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Treatment practices and confidence in the management of pediatric metabolic bone disorders
Hormone Research in Paediatrics ( IF 3.2 ) Pub Date : 2022-05-13 , DOI: 10.1159/000524994
Emma McCutcheon 1 , Sasigarn A Bowden 2 , Halley Wasserman 3 , Alicia Diaz-Thomas 4 , Vid Bijelić 5 , Laura K Bachrach 6 , Marie-Eve Robinson 1, 7
Affiliation  

Introduction: Pediatric metabolic bone diseases encompass a wide variety of disorders that can be challenging to diagnose and treat because of inadequate physician training about optimal management. Methods: As practice variation and confidence levels may impact clinical outcome, we sought to assess physician confidence in managing pediatric metabolic bone disorders and the spectrum of treatment practices among members of the Pediatric Endocrine Society (PES) and the Canadian Pediatric Endocrine Group (CPEG). Questionnaires were distributed via e-mail to all members of the PES and CPEG and 244 were completed. Responses were summarized using descriptive statistics, and proportions were compared using χ2 or Fisher’s exact tests, as appropriate. Results: Variations were observed amongst the respondents’ confidence in the management of bone disorders and in the criteria used to initiate/discontinue intravenous bisphosphonates or prescribe burosumab therapy. Respondents felt confident with the management of four out of 20 pediatric bone conditions (confidence was defined as >90% of respondents reporting feeling “somewhat confident” or “very confident”). Physicians working in a bone clinic were more confident in prescribing burosumab for the treatment of X-linked hypophosphatemic rickets compared to those not working in a bone clinic (65% versus 47%, p = 0.03). Most respondents (52%) reported having received inadequate training in pediatric bone and mineralization disorders. Discussion/conclusion: Dedicated training, knowledge acquisition and education resources are needed to increase confidence and standardize the use of bone-targeted therapies.


中文翻译:

治疗实践和对小儿代谢性骨病管理的信心

简介:儿科代谢性骨病包括多种疾病,由于医生对最佳管理的培训不足,这些疾病的诊断和治疗可能具有挑战性。方. 问卷通过电子邮件分发给 PES 和 CPEG 的所有成员,完成了 244 份。使用描述性统计总结反应,并酌情使用 χ2 或 Fisher 精确检验比较比例。结果:在受访者对骨疾病管理的信心以及用于启动/停止静脉注射双膦酸盐或开具布罗单抗治疗的标准中观察到差异。受访者对 20 种儿科骨骼疾病中的 4 种的管理充满信心(信心被定义为 >90% 的受访者表示感到“有些信心”或“非常有信心”)。与不在骨科诊所工作的医师相比,在骨科诊所工作的医师对开具布罗单抗治疗 X 连锁低磷性佝偻病更有信心(65% 对 47%,p = 0.03)。大多数受访者 (52%) 报告说在儿科骨骼和矿化障碍方面接受的培训不足。讨论/结论:专门的培训,
更新日期:2022-05-13
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