Survey of Physician Diagnostic Practices for Patients with Acute Diarrhea: Clinical and Public Health Implications

To understand physician practices regarding the diagnosis of acute diarrheal diseases, we conducted a survey, in 1996, of 2839 physicians in Connecticut, Georgia, Minnesota, Oregon, and California. Bacterial stool culture was requested for samples from the last patient seen for acute diarrhea by 784...

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Bibliographic Details
Published in:Clinical infectious diseases 2004-04, Vol.38 (Supplement-3), p.S203-S211
Main Authors: Hennessy, Thomas W., Marcus, Ruthanne, Deneen, Valerie, Reddy, Sudha, Vugia, Duc, Townes, John, Bardsley, Molly, Swerdlow, David, Angulo, Frederick J.
Format: Article
Language:English
Subjects:
Acute Disease
Clinical Laboratory Techniques
Diarrhea
Diarrhea - diagnosis
Diarrhea - microbiology
Education, Medical
Emerging diseases
Epidemiology
Escherichia coli
Escherichia coli O157 - isolation & purification
Family practice
Feces - microbiology
Fever
Humans
Medical practice
Operating rooms
Physicians
Practice Patterns, Physicians
Preventive medicine
Public health
Vibrio
Yersinia
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Summary:To understand physician practices regarding the diagnosis of acute diarrheal diseases, we conducted a survey, in 1996, of 2839 physicians in Connecticut, Georgia, Minnesota, Oregon, and California. Bacterial stool culture was requested for samples from the last patient seen for acute diarrhea by 784 (44%; 95% confidence interval, 42%–46%) of 1783 physicians. Physicians were more likely to request a culture for persons with acquired immune deficiency syndrome, bloody stools, travel to a developing country, diarrhea for >3 days, intravenous rehydration, or fever. Substantial geographic and specialty differences in culture-request practices were observed. Twenty-eight percent of physicians did not know whether stool culture included testing for Escherichia coli O157:H7; 40% did not know whether Yersinia or Vibrio species were included. These variabilities suggest a need for clinical diagnostic guidelines for diarrhea. Many physicians could benefit from education to improve their knowledge about tests included in routine stool examinations.
ISSN:1058-4838
1537-6591
DOI:10.1086/381588