March/April - West Virginia State Medical Association

West Virginia Bureau for Public Health | NEWS
Survey of Knowledge and Practices of West Virginia Providers
Regarding Enteric Pathogens and Laboratory Testing, 2011
In order to evaluate enteric
pathogen surveillance in West
Virginia, a survey of healthcare
providers was conducted to assess
their knowledge and practices
regarding enteric pathogens
and laboratory testing.
Surveys containing questions on
lab testing, patient management
practices, and clinical vignettes from
the Diagnosis and Management
of Foodborne Illnesses, A Primer
for Physicians were mailed to all
3147 licensed MDs, PAs and DOs
through the WV Boards of Medicine
and Osteopathy. Of the 532 (18%)
respondents, there were 389 (73%)
actively practicing providers who
reported seeing at least 1 patient
in the previous 6 months with
diarrheal illness. The analysis
was limited to these providers.
Family and internal medicine
specialists comprised 66% of
respondents. The majority of
respondents practiced in a
private office or clinic (57%).
Mean (median) number of
years in practice was 19 (18).
Fifty-five percent of providers
utilize lab testing as part of their
usual management of patients with
diarrheal illness; however 80%
make treatment decisions prior to
confirming the cause of diarrhea.
There was no significant difference
in testing practices by years in
practice or by specialty, with the
exception of pediatrics. Pediatric
providers were less likely than other
providers to utilize lab testing as
part of their usual management.
Of the 173(47%) providers who
do not routinely test their patients,
90(52%) indicated that test results
would not change the treatment plan,
41(24%) cited the cost to the patient
as a barrier and 26(15%) indicated
they would test if symptoms persist.
In a clinical scenario specific to
parasitic pathogens, 286(73%) of
providers provided the correct likely
diagnoses and 245(63%) indicated
correct laboratory testing, with no
significant difference by provider
specialty. In a scenario specific to
bacterial pathogens, only 103(26%)
of providers gave the correct
diagnoses and, 95(24%) indicated
appropriate laboratory tests. For
bacterial pathogens, infectious
disease specialists were statistically
more likely to indicate the correct
diagnoses and appropriate laboratory
tests (OR: undef, p