Claudia Martinez-Rios1,2,3, Jennifer R McKinney1,4, Nadine Al-Aswad5, Arvind K Shergill2, Ada F Louffat1, Lillian Sung6,7, Karen E Thomas1,2, Suzanne Schuh7,8, George Tomlinson9, Rahim Moineddin10, Andrea S Doria1,2. 1. Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada. 2. Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. 3. Department of Medical Imaging, CHEO, University of Ottawa, Ottawa, Ontario, Canada. 4. Graduate Entry Medical School, The University of Limerick, Limerick, Ireland. 5. Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. 6. Department of Pediatrics, Division of Haematology-Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada. 7. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. 8. Division of Pediatric Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. 9. Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada. 10. Department of Family and Community Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Abstract
OBJECTIVES: To determine parental preferences for diagnostic imaging tests (DITs) for paediatric appendicitis, to rank the attributes impacting the DIT selection and to identify DIT attributes that would cause parents to switch their DIT. METHODS: Parents of children who had an abdominal ultrasound (US) for right lower quadrant pain were interviewed. Two DITs were compared at a time, parents were asked to indicate their preferred test and to rank its attributes according to the impact each attribute had on their selection. The strength of their preference for the chosen DIT was measured by systematically adjusting attributes of the chosen DIT until the parent changed their choice. RESULTS: Fifty parents were interviewed. For US versus CT, more parents preferred US (68%, P=0.02) with higher importance ranks for cancer risk (P<0.0001), test accuracy (P=0.04), pain during test (P=0.3), and scan length (P<0.0001); and lower ranks for sedation (P=0.02), intravenous (IV) (P<0.02), and oral contrast (P=0.06). For US versus MRI, parents preferred MRI (78%, P<0.0001) with higher importance ranks for accuracy (P=0.2), pain during test (P=0.06), and scan length (P=0.06); and lower for noise (P<0.0001), claustrophobia (P<0.0001), use of IV contrast (P=0.06), and sedation (P=0.2). CONCLUSION: US and MRI were the DIT preferred by parents for the investigation of acute paediatric appendicitis.
OBJECTIVES: To determine parental preferences for diagnostic imaging tests (DITs) for paediatric appendicitis, to rank the attributes impacting the DIT selection and to identify DIT attributes that would cause parents to switch their DIT. METHODS: Parents of children who had an abdominal ultrasound (US) for right lower quadrant pain were interviewed. Two DITs were compared at a time, parents were asked to indicate their preferred test and to rank its attributes according to the impact each attribute had on their selection. The strength of their preference for the chosen DIT was measured by systematically adjusting attributes of the chosen DIT until the parent changed their choice. RESULTS: Fifty parents were interviewed. For US versus CT, more parents preferred US (68%, P=0.02) with higher importance ranks for cancer risk (P<0.0001), test accuracy (P=0.04), pain during test (P=0.3), and scan length (P<0.0001); and lower ranks for sedation (P=0.02), intravenous (IV) (P<0.02), and oral contrast (P=0.06). For US versus MRI, parents preferred MRI (78%, P<0.0001) with higher importance ranks for accuracy (P=0.2), pain during test (P=0.06), and scan length (P=0.06); and lower for noise (P<0.0001), claustrophobia (P<0.0001), use of IV contrast (P=0.06), and sedation (P=0.2). CONCLUSION: US and MRI were the DIT preferred by parents for the investigation of acute paediatric appendicitis.
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