title: Survey of physician diagnostic practices for patients with acute diarrhea: clinical and public health implications.
abstract: 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.
authors.affiliation: Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. tbh0@cdc.gov
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Hennessy
authors.forename: Ruthanne
authors.initials: R
authors.lastname: Marcus
authors.forename: Valerie
authors.initials: V
authors.lastname: Deneen
authors.forename: Sudha
authors.initials: S
authors.lastname: Reddy
authors.forename: Duc
authors.initials: D
authors.lastname: Vugia
authors.forename: John
authors.initials: J
authors.lastname: Townes
authors.forename: Molly
authors.initials: M
authors.lastname: Bardsley
authors.forename: David
authors.initials: D
authors.lastname: Swerdlow
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Angulo
mesh_terms: D000208:Acute Disease; D019411:Clinical Laboratory Techniques; D003967:Diarrhea / Q000175:diagnosis* / Q000382:microbiology; D004501:Education, Medical; D019453:Escherichia coli O157 / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology*; D006801:Humans; D010820:Physicians; D010818:Practice Patterns, Physicians'