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M9610303.TXT
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1996-01-30
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Document 0303
DOCN M9610303
TI Ability of primary care physicians to recognize physical findings
associated with HIV infection.
DT 9601
AU Paauw DS; Wenrich MD; Curtis JR; Carline JD; Ramsey PG; Department of
Medicine, University of Washington School of; Medicine, Seattle, USA.
SO JAMA. 1995 Nov 1;274(17):1380-2. Unique Identifier : AIDSLINE
MED/96042066
AB OBJECTIVE--To assess the ability of primary care physicians to identify
physical findings associated with human immunodeficiency virus (HIV)
infection. DESIGN--Standardized patient examination. PARTICIPANTS--A
total of 134 general internists and family practitioners were randomly
selected after stratifying by year of medical school graduation,
specialty, and experience caring for patients with HIV infection. MAIN
OUTCOME MEASURES--Recognition of physical findings of Kaposi's sarcoma,
oral hairy leukoplakia, and diffuse lymphadenopathy. RESULTS--Despite
being directed by presenting histories to sites of prominent physical
abnormalities, only 23 (25.8%) of 89 physicians evaluating a patient
with Kaposi's sarcoma and 22 (22.7%) of 97 physicians evaluating a
patient with oral hairy leukoplakia detected and correctly diagnosed the
abnormalities. Twenty-three (17%) of 133 physicians detected diffuse
lymphadenopathy in a patient complaining of fatigue, fever, and
arthralgias. Physicians with the most experience treating patients with
HIV infection more frequently identified oral hairy leukoplakia, but HIV
experience did not influence identification of Kaposi's sarcoma or
detection of lymphadenopathy. There were no differences between general
internists and family practitioners or among physicians by year of
medical school graduation in identifying the three physical findings
associated with HIV infection. CONCLUSIONS--Primary care physicians may
frequently miss important physical findings related to HIV infection
during patient examinations.
DE *Clinical Competence/STATISTICS & NUMER DATA *Family
Practice/STATISTICS & NUMER DATA Human HIV
Infections/COMPLICATIONS/*DIAGNOSIS Leukoplakia,
Hairy/DIAGNOSIS/ETIOLOGY Linear Models Lymphatic
Diseases/DIAGNOSIS/ETIOLOGY Physicians, Family/STATISTICS & NUMER DATA
Sarcoma, Kaposi's/DIAGNOSIS/ETIOLOGY Schools, Medical/STATISTICS &
NUMER DATA 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).