Observation of the Effectiveness of a Diagnostic Model for Acute Abdominal Pain Based on the Etiology Checklist and Process Thinking

Hong-ming Pan,1,* Hong-ling Li,2,* Zhang-shun Shen,2 Hui Guo,2 Qian Zhao,2 Jian-guo Li2 1Graduate School of Hebei Medical University, Shijiazhuang, 050051, People’s Republic of China; 2Department of Emergency Medicine, Hebei General Hospital, Shijiazhuang, 050051, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jian-guo LiDepartment of Emergency Medicine, Hebei General Hospital, No. 348 Heping West Road, Shijiazhuang, 050051, People’s Republic of ChinaTel +86 31185988361Email li_jian_guo3@163.comObjective: The present study aimed to explore the effectiveness of the etiology checklist and process thinking in the differential diagnosis for acute abdominal pain.Methods: A retrospective design was used to include 5,403 patients with acute abdominal pain in the Emergency Department of Hebei Provincial People’s Hospital. The patients with acute abdominal pain between July and December 2017 in whom the etiology checklist and process thinking were not implemented were selected as the traditional group. Those with acute abdominal pain between July and December 2018 in whom the etiology checklist and process thinking were implemented were selected as the process thinking group. The clinical data, such as the emergency length of stay, hospitalization expenses, hospitalization length of stay, diagnostic accuracy, and outcome, were compared between the two groups.Results: For patients at emergency level 2 and above, the average emergency length of stay was shorter in the process thinking group than in the traditional group, while the average emergency length of stay was longer for patients at emergency level 3. For hospitalized patients at emergency level 2 and above and patients at emergency level 3, those in the process thinking group had improved diagnostic accuracy, shorter average hospitalization length of stay, reduced average hospital expenses, and improved outcomes. In the comparison among six physicians, the results in the traditional group were inconsistent and statistically different in terms of the average emergency length of stay and diagnostic accuracy, while the results in the process thinking group tended to be consistent. The differences were not statistically different.Conclusion: The diagnostic model for acute abdominal pain based on the etiology checklist and process thinking could improve the diagnostic accuracy and outcomes for patients with acute abdominal pain.Keywords: acute abdominal pain, emergency diagnosis, lateral thinking, process thinking