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Parents and clinicians don’t always share the same perspectives on diagnostic testing for pediatric diarrhea, according to a qualitative study published in JAMA Network Open. Interviews with 44 parents (91% female; median age, 34 years) and 16 clinicians (69% female; median age, 42 years) from 5 urgent care sites and 1 emergency department in Utah demonstrated the differences in their expectations. Participating clinicians included 10 physicians (62%) and 6 nurse practitioners or physician assistants (38%). Parents in the study noted that they were motivated to seek care mainly for reassurance, understanding the cause of their child’s illness, and to seek treatment, often viewing diagnostic tests as valuable for all of these motivating factors. However, clinicians were generally skeptical about the value of diagnostics, noting that results rarely change the course of clinical management of pediatric diarrhea, except in unique cases (eg, bloody stools, prolonged duration of diarrhea, or travel history). “If the kid’s well, there’s a good chance even if it is bacterial, they’ll get over it,” an urgent care physician with more than 10 years in practice said in the survey. Even so, clinicians sometimes order tests to satisfy parents. Both groups recognized the possible risks of unnecessary testing, such as inappropriate antibiotic use and additional costs.
Tools for reference: Clinicians saw potential value in electronic clinical decision support tools to guide evidence-based decisions and help support communication with families, although they also believe a decision tool could not be used in every pediatric diarrhea case.