Diagnostic value of infantile strider: a perceptual test

Introduction: strider is the most common presenting symptom of pediatric ai rway obstruction, yet its value in clinical diagnosis is undetermined. The purpose of this study was to determine what diagnostic information was avai lable to clinicians based entirely on listening to infantile strider. Metho d: ten taped samples of strider and corresponding clinical summaries were i ndependently scored by Pediatric Otolaryngologists and their trainees. Resp ondents were asked to score the 'perceived' severity of the strider based o n their aural perception. Participants were recruited by an advertisement o n the Internet Pediatric Otolaryngology forum. Thirty-eight consultants and 22 trainees responded. The responses were compared to known outcomes in th e ten patients presented. Results: listening to strider in isolation result ed in respondents performing at the level of chance when their score of 'pe rceived' severity was compared to the known clinical outcome. When the clin ical summaries (of the same patients) were scored, the level of performance significantly improved (P < 0.001). There was no difference in the level o f performance when responses of trainees were compared with consultants, al though there was a trend towards improved performance by the consultants. C onclusion: the importance of infantile strider judged in isolation is of li mited diagnostic value. Clinical information contributes significantly to t he rating of strider severity. The combination of both clinical and auditor y information will likely improve diagnostic acumen. (C) 1999 Elsevier Scie nce Ireland Ltd. All rights reserved.