Impact of Clinical Experience and Diagnostic Performance in Patients with Acute Abdominal Pain

Background. The aims were to evaluate the importance of the formal competence of the emergency department physician, the patient’s time of arrival at the emergency department, and the use of a structured schedule for investigation of patients with acute abdominal pain. Methods. Patients attending th...

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Main Authors: Helena Laurell, Lars-Erik Hansson, Ulf Gunnarsson
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2015/590346
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author Helena Laurell
Lars-Erik Hansson
Ulf Gunnarsson
author_facet Helena Laurell
Lars-Erik Hansson
Ulf Gunnarsson
author_sort Helena Laurell
collection DOAJ
description Background. The aims were to evaluate the importance of the formal competence of the emergency department physician, the patient’s time of arrival at the emergency department, and the use of a structured schedule for investigation of patients with acute abdominal pain. Methods. Patients attending the Mora Hospital with acute abdominal pain from 1997 to 2000 were registered prospectively according to a structured schedule. Registration included history, symptoms, signs, preliminary diagnosis, surgery and final diagnosis after at least one year.  Results. 3073 acute abdominal pain patients were included. The preliminary diagnosis, as compared with the final diagnosis, was correct in 54% (n=1659). Previously, during 1996, a base-line registration of 790 patients had a 58% correct diagnoses  (n=458). A majority of the patients (n=2699; 88%) were managed by nonspecialists. The proportion of correct diagnoses was 54% (n=759) for pre-registrar house officers and 55% (n=443) for senior house officers. Diagnostic performance at the emergency department was independent of patient’s time of arrival. Conclusions. A structured schedule for investigation did not improve the diagnostic precision at the emergency department in patients with acute abdominal pain. The diagnostic performance was independent of the formal competence of the physician and the patient's time of arrival.
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spelling doaj-art-522ac16766444ef29744ce625ad4824f2025-02-03T05:58:25ZengWileyGastroenterology Research and Practice1687-61211687-630X2015-01-01201510.1155/2015/590346590346Impact of Clinical Experience and Diagnostic Performance in Patients with Acute Abdominal PainHelena Laurell0Lars-Erik Hansson1Ulf Gunnarsson2Department of Surgery, Mora Hospital, 792 51 Mora, SwedenDepartment of Surgery, Sahlgrenska University Hospital, 413 46 Gothenburg, SwedenDepartment of Surgical and Perioperative Sciences, Umeå University, 901 95 Umeå, SwedenBackground. The aims were to evaluate the importance of the formal competence of the emergency department physician, the patient’s time of arrival at the emergency department, and the use of a structured schedule for investigation of patients with acute abdominal pain. Methods. Patients attending the Mora Hospital with acute abdominal pain from 1997 to 2000 were registered prospectively according to a structured schedule. Registration included history, symptoms, signs, preliminary diagnosis, surgery and final diagnosis after at least one year.  Results. 3073 acute abdominal pain patients were included. The preliminary diagnosis, as compared with the final diagnosis, was correct in 54% (n=1659). Previously, during 1996, a base-line registration of 790 patients had a 58% correct diagnoses  (n=458). A majority of the patients (n=2699; 88%) were managed by nonspecialists. The proportion of correct diagnoses was 54% (n=759) for pre-registrar house officers and 55% (n=443) for senior house officers. Diagnostic performance at the emergency department was independent of patient’s time of arrival. Conclusions. A structured schedule for investigation did not improve the diagnostic precision at the emergency department in patients with acute abdominal pain. The diagnostic performance was independent of the formal competence of the physician and the patient's time of arrival.http://dx.doi.org/10.1155/2015/590346
spellingShingle Helena Laurell
Lars-Erik Hansson
Ulf Gunnarsson
Impact of Clinical Experience and Diagnostic Performance in Patients with Acute Abdominal Pain
Gastroenterology Research and Practice
title Impact of Clinical Experience and Diagnostic Performance in Patients with Acute Abdominal Pain
title_full Impact of Clinical Experience and Diagnostic Performance in Patients with Acute Abdominal Pain
title_fullStr Impact of Clinical Experience and Diagnostic Performance in Patients with Acute Abdominal Pain
title_full_unstemmed Impact of Clinical Experience and Diagnostic Performance in Patients with Acute Abdominal Pain
title_short Impact of Clinical Experience and Diagnostic Performance in Patients with Acute Abdominal Pain
title_sort impact of clinical experience and diagnostic performance in patients with acute abdominal pain
url http://dx.doi.org/10.1155/2015/590346
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