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220 Chapter 10 TABLE 2. Guideline awareness and implementation of items of the medical history and physical examination and non-pharmacological interventions, compared between responders from the Netherlands and the U.S., pediatricians and pediatric gastroenterologists, physicians with more than 15 years of experience and physicians with less experience. Fisher’s exact test, bold if P < .05. Country Profession Experience NL (n=110) n (%, CI) U.S. (n=218) n (%, CI) P -value Pediatrics (n=191) n (%, CI) Pediatric GI (n=137) n (%, CI) P -value ≤ 15 years (n=166) n (%, CI) > 15 years (n=162) n (%, CI) P -value Familiarity with the guideline Unfamiliar with the guideline 18/110 (16% [CI 11-24]) 82/217 (38% [CI 32-44]) <.001 95/190 (50% [CI 43-57]) 5/137 (4% [CI 2-8]) <.001 29/166 (17% [CI 12-24]) 71/161 (44% [CI 37-52]) <.001 Frequent implementation of items of the medical history and physical examination a Inquiry sexual abuse 34/110 (31% [CI 23-40]) 24/218 (11% [CI 8-16]) <.001 36/191 (19% [CI 14-25]) 22/137 (16% [CI 11-23]) .559 25/166 (15% [CI 10-21]) 33/162 (20% [CI 15-27]) .247 Perianal inspection 98/110 (89% [CI 82-94]) 157/218 (72% [CI 66-78]) <.001 128/191 (67% [CI 60-73]) 127/137 (93% [CI 87-96]) <.001 138/166 (83% [CI 77-88]) 117/162 (72% [CI 65-79]) .024 Digital rectal examination 37/108 (34% [CI 26-44]) 99/217 (46% [CI 39-52]) .057 46/189 (24% [CI 19-31]) 90/136 (66% [CI 58-74]) <.001 82/165 (50% [CI 42-57]) 54/160 (34% [CI 27-41]) .005 Non-pharmacological interventions Toilet training program 95/108 (88% [CI 80-93]) 198/217 (91% [CI 87-94]) .429 163/189 (86% [CI 81-90]) 130/136 (96% [CI 91-98]) .005 156/165 (95% [CI 90-97]) 137/160 (86% [CI 80-90]) .009 Optimizing fluid intake 96/108 (89% [CI 82-94]) 185/217 (85% [CI 80-89]) .396 171/189 (90% [CI 85-94]) 110/136 (81% [CI 73-87]) .014 145/165 (88% [CI 82-92]) 136/160 (85% [CI 79-90]) .518 Optimizing fiber intake 87/108 (81% [CI 72-87]) 180/217 (83% [CI 77-87]) .645 169/189 (89% [CI 83-93]) 98/136 (72% [CI 64-79]) <.001 127/165 (77% [CI 70-83]) 140/160 (88% [CI 81-92]) .014 Keeping a defecation diary 94/108 (87% [CI 79-92]) 109/217 (50% [CI 44-57]) <.001 119/189 (63% [CI 56-70]) 84/136 (62% [CI 53-70]) .908 111/165 (67% [CI 60-74]) 92/160 (58% [CI 50-65]) .086 Implementing reward system 67/108 (62% [CI 53-71]) 129/217 (59% [CI 53-66]) .718 100/189 (53% [CI 46-60]) 96/136 (71% [CI 62-78]) .001 112/165 (68% [CI 60-75]) 84/160 (53% [CI 45-60]) .006 Prescribing pre- or probiotics 8/108 (7% [CI 4-15]) 69/217 (32% [CI 26-38]) <.001 51/189 (27% [CI 21-34]) 26/136 (19% [CI 13-27]) .113 37/165 (22% [CI 17-29]) 40/160 (25% [CI 19-32]) .604 a Self-reported frequency with which items from the medical history and physical examination were put into practice was scored on a 5-point Likert scale (never-rarely-sometimes-often-always), the answers ‘often’or ‘always’on the 5-point Likert scale were considered as ‘frequent’performance of an item.