The results of the evaluation of the international testing “Acute reactions in children” among doctors of various specialties

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Abstract

BACKGROUND: Anaphylaxis is a situation at risk of death; thus, doctors should identify its symptoms and provide emergency assistance.

AIMS: This study aimed to conduct a comparative analysis of the level of knowledge on anaphylaxis in children among doctors of various specialties.

MATERIALS AND METHODS: The study was conducted anonymously using an online questionnaire (Google Forms) among five groups of doctors: allergologists-immunologists, resuscitators-anesthesiologists, emergency physicians, pediatricians, and students of accredited university graduates. The questionnaire included six tasks on anaphylaxis in children and four tasks on other diseases similar to anaphylaxis, and each had two questions (diagnosis and treatment) with three answer options; if one was correct, 1 point was given.

RESULTS: A total of 1871 respondents from nine countries filled out the questionnaire correctly. The average score of the allergists on anaphylaxis tasks was the highest (9 of 12 points) in comparison with other groups (p <0.001). The average score on non-anaphylaxis tasks was high in all groups (7 of 8 points). The level of knowledge of respondents did not correlate with age and work experience. In anaphylaxis tasks, allergists made the appropriate diagnosis in 83.7% of cases; resuscitators, pediatricians, and students in 2/3; and emergency physicians in 50%. For the treatment of anaphylaxis, allergists prescribed epinephrine in 66.7% of cases, and other groups in ≤50%. The percentage of correct answers in the tasks of food anaphylaxis (diagnosis) was the highest among allergists (80–96%), compared with other groups (36–82%) (p <0.001). In the treatment of food anaphylaxis, allergists prescribed epinephrine more often (up to 85%) than other groups (up to 77%). The percentage of correct responses of drug anaphylaxis among all groups was high; however, resuscitators responded better (diagnosis, 94%; treatment, 64%). All groups had the lowest level of knowledge on idiopathic anaphylaxis.

CONCLUSIONS: Anaphylaxis can be underdiagnosed in 50% of pediatric cases; however, even with correct diagnosis, epinephrine is not prescribed in half of the cases. Thus, increasing and maintaining the level of knowledge on anaphylaxis among doctors of various specialties, regardless of their length of service, are necessary.

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About the authors

Alexander N. Pampura

Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery

Email: apampura@pedklin.ru
ORCID iD: 0000-0001-5039-8473
SPIN-code: 9722-7961

MD, Dr. Sci. (Med.)

Russian Federation, Moscow

Natalia V. Esakova

Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery

Author for correspondence.
Email: env007@rambler.ru
ORCID iD: 0000-0001-8792-2670
SPIN-code: 6924-9726

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Daria D. Dolotova

The Russian National Research Medical University named after N.I. Pirogov

Email: dariadolotova@gmail.com
ORCID iD: 0000-0002-5538-1109
SPIN-code: 1087-6660

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Moscow

Irina N. Zakharova

Russian Medical Academy of Continuous Professional Education

Email: kafedra25@yandex.ru
ORCID iD: 0000-0003-4200-4598
SPIN-code: 4357-3897

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Nikolai F. Plavunov

Station of ambulance and emergency care name A.C. Puchkova; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: info@ssnmp.mosgorzdrav.ru
ORCID iD: 0000-0002-1296-1760
SPIN-code: 8797-7297

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow; Moscow

Andrey U. Lekmanov

The Russian National Research Medical University named after N.I. Pirogov

Email: aulek@rambler.ru
ORCID iD: 0000-0003-0798-1625
SPIN-code: 3630-5061

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Valeriy A. Kadyshev

Station of ambulance and emergency care name A.C. Puchkova; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: damask51@rambler.ru
ORCID iD: 0000-0002-1414-5337
SPIN-code: 7739-3396

MD, Cand. Sci. (Med.)

Russian Federation, Moscow; Moscow

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Supplementary files

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2. Fig. 1. Statistical significance of differences between groups, according to the score. Bold ― p <0.05; bold font with color highlighting ― p <0.005 (significance with the Bonferroni amendment).

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3. Fig. 2. Percentage of points scored from the maximum possible for the diagnosis and treatment of anaphylaxis (Q1,2,4,5,6,10).

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4. Fig. 3. The frequency of correct responses and the statistical significance of differences between groups separately for each task for the diagnosis and treatment of anaphylaxis (Q1,2,4,5,6,10) (bold ― p <0.05; bold font with color highlighting ― p <0.005 (significance with the Bonferroni amendment)).

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