Accuracy of diagnosis of patients referred to paediatric surgical clinics

Abstract

Background: Medical knowledge continues to expand exponentially. Continuing medical education has necessarily, become a requisite for maintenance of certification of physicians. It is aimed at maintaining knowledge and skills and acquiring new skills as technology advances. This study aims to assess the accuracy of reasons for referrals for paediatric surgical consultations.

Materials And Methods: Referrals to the Paediatric Surgical Outpatient Unit of University of Ilorin Teaching Hospital between July 2013 and May 2015 were prospectively studied. Data recorded include age of patients, source of, and reasons for referral, and diagnosis after Paediatric surgical consultation. Analysis was done with Statistical Package for Social Sciences (SPSS) software Version 20.

Results: A total of 230 patients were seen at a mean age of 45.5 (± 47.4) months. There were 176 (76.5%) males, 53 (23.0%) females, and 1 (0.4%) with indeterminate sex. Majority, 104 (45.2%) of the referrals came from primary care physicians, 46 (20%) self-referrals, and remainder, 80 (34.8%) were from other sources. Of the 184 (80%) patients that were referred by physicians, 148 (64.3%) had a clinical diagnosis in their referral notes, no diagnosis in 12 (5.2%) and in 24 (10.4%), there were descriptions of presentation rather than diagnosis. The two most common indications for paediatric surgical consultation were Inguinal Hernia 32 (13.9%) and Hydrocele 31 (13.5%). In all, the diagnosis of the referring physicians were accurate in 111 (48.3%) out of 184 patients referred, giving an accuracy rate of 60.3%. The accuracy was higher amongst private hospitals (65.5%), Primary care physicians (64.4%) and paediatricians (64.0%) than among other government hospitals (34.6%), P value 0.039.

Conclusion: Accuracy of diagnoses amongst referrals to paediatric surgical specialist clinic is fair; however, there is need for improvement. This can be achieved by intensifying the Continuing Medical Education programmes.

Keywords: Misdiagnosis, delayed intervention, referral, children surgery