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1996-02-26
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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).