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• W4230880863 abstract "Abstract Background: The chief or presenting complaint is the reason for seeking health care, often in the patient’s own words. In limited resource settings, a diagnosis-based approach to quantifying burden of disease is not possible, partly due to limited availability of an established lexicon or coding system. Collaboration with World Health Organization colleagues resulted in the creation of a pilot symptom list representing an attempt to standardize undifferentiated chief complaints in emergency and acute care settings. A validated universal chief complaint list would profoundly benefit clinicians, researchers, and policymakers world-wide by allowing the communication and development of system-level priorities based around the signs and symptoms most often experienced by the patients being served. Methods: This study was incorporated as a part of a larger prospective observational study on human immunodeficiency virus testing in Emergency Departments in South Africa. The pilot symptom list was used for chief complaint coding in three Emergency Departments. Data was collected on 3,357 patients using paper case report forms. Chief complaint terms were reviewed by two study team members to determine the frequency of concordance between the coded chief complaint term and the selected symptom(s) from the pilot symptom list. Results: Overall, 3,537 patients’ chief complaints were reviewed, of which 640 were identified as ‘potential mis-matches’. When considering the 191 confirmed mis-matches (29.8%), the Delphi process identified 6 (3.1%) false mismatches and 185 (96.9%) true mismatches. Significant chief-complaint clustering was identified with 9 sets of complaints frequently selected together for the same patient. “Pain” was used 2,076 times for 58.7% of all patients. Testing for validity and functionality of the initial draft dataset via user feedback and expert-panel modified Delphi analysis resulted in several substantial changes to the pilot symptom list. Conclusions: This study found that the pilot symptom list with aforementioned modifications could be applied to a low resource emergency system. Recommendations for additions, modifications, and/or deletions from the draft chief complaint list will improve validity and functionality of the list in low resource environments. Selecting a patient’s chief complaint from a validated list offers a vital tool to help triage patients, streamline emergency care delivery, and improve patient outcomes." @default.
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• W4230880863 date "2020-12-16" @default.
• W4230880863 modified "2023-09-27" @default.
• W4230880863 title "Validating a Chief Compliant List for Low Resource Settings: A Methodologic Case Study" @default.
• W4230880863 doi "https://doi.org/10.21203/rs.3.rs-127449/v1" @default.
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