Do Parents and Physicians Differ in Making Decisions About Acute Otitis Media?

초록

Objectives We wanted to discover how parents differ from physicians in making decisions about how to treat a child who may have acute otitis media (AOM). Study Design We used questionnaires that required participants to judge die probability of AOM or choose treatment for 2 sets of 46 paper scenarios of hypothetical children aged 15 months who might have AOM, and they subsequently rated the importance of individual cues and described their attitudes and opinions related to health care and AOM. Population Convenience samples of 19 US family physicians, 35 French generalists, 21 French pediatricians, 52 US parents, and 86 French parents were included. Outcomes measured The primary outcomes were the judgment policies-the weights placed on each of the scenario cues when making decisions-that were derived for each individual and each group by multiple linear regression. Results The mean judged probabilities of AOM were nearly the same for all groups: 50% for the US physicians, 51% for the US parents, 52.5% for the French physicians, and 52% for the French parents. The percentages of cases treated with antibiotics did not differ: 53% for US physicians, 45% for US parents, 53% for French physicians, and 51% for French parents. All groups gave greatest weight to the physical examination cues for decisions about both diagnosis and treatment. The parents paid little attention to the cues that reflected parental concerns. Conclusions US and French parents were very similar to physicians in their judgments and treatment choices regarding AOM. They appear to be able to adopt the physician's point of view and to be selective in the use of antibiotics.

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