Document 0435
 DOCN  M9620435
 TI    Ability of primary care physicians to diagnose and manage Pneumocystis
       carinii pneumonia.
 DT    9602
 AU    Curtis JR; Paauw DS; Wenrich MD; Carline JD; Ramsey PG; Department of
       Medicine, University of Washington, Seattle, 98195,; USA.
 SO    J Gen Intern Med. 1995 Jul;10(7):395-9. Unique Identifier : AIDSLINE
       MED/96066068
 AB    This study assesses the ability of primary care physicians to diagnose
       and manage Pneumocystis carinii pneumonia (PCP) in a standardized
       patient (SP) with unidentified HIV infection. One hundred thirty-four
       primary care physicians from five Northwest states saw an SP with
       unidentified HIV infection who presented with symptoms, chest
       radiograph, and arterial blood gas results classic for PCP.
       Seventy-seven percent of the physicians included PCP in their
       differential diagnoses and 71% identified the SP's HIV risk. However,
       only a minority of the physicians indicated that they would initiate an
       appropriate diagnostic evaluation or appropriate therapy: 47% ordered a
       diagnostic test for PCP, 31% initiated an antibiotic appropriate for
       PCP, and 12% initiated an adequate dose of trimethoprim -
       sulfamethoxazole. Only 6% of the physicians initiated adjunctive
       prednisone therapy, even though prednisone was indicated because of the
       blood gas result. These findings suggest significant delay in diagnosis
       and treatment had these physicians been treating an actual patient with
       PCP.
 DE    *Clinical Competence  Comparative Study  Diagnosis, Differential
       Diagnostic Errors  Human  HIV Infections/DIAGNOSIS  Physicians,
       Family/*STANDARDS  Pneumonia, Pneumocystis carinii/*DIAGNOSIS  Support,
       Non-U.S. Gov't  Support, U.S. Gov't, P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).