Community Medicine Rants – Should We Listen to Parents?

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Nurses Edition Commentary

Lisa Chavez, RN and Kathy Garvin, RN
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Richard C., M.D. -

Logically this can't be correct. People don't come to the ER if they don't think something is wrong. Since the admission rate in peds is very low, the specificity here has to be terrible.

Alfred S., M.D. -

Richard:

Your are correct in that most people will justify their visit to the ED with an explanation that they believe they or their family member is sick or injured. However, the articles looking at the comment "There is something different about this illness" are not about diagnostic testing. If that were the case, then you are correct the specificity would be important and yes it is likely low. They are only about screening, and for screening purposes it is the sensitivity and + LR that are most important. The only intent of the studies was to raise awareness that when a caretaker believes there is a difference of importance in a child, then the clinician should look a little more closely at that patient. Besides, this is the world's most inexpensive screening test, $0 and a few minutes of listening.

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