title: A national survey of practice patterns: temporal artery biopsy.
abstract: OBJECTIVE
  To assess current clinical practice patterns for temporal artery biopsy (TAB) among clinicians in establishing the diagnosis of giant cell arteritis.
  
  
  METHODS
  A survey was sent via e-mail using the Survey Monkey website (www.surveymonkey.com; accessed January 24, 2013). The survey initially was sent in July 2010 and continued through October 2010.
  
  
  METHODS
  The survey was sent via e-mail to the members and affiliates of the American Society of Ophthalmic Plastic and Reconstructive Surgery, the North American Neuro-Ophthalmology Society, and the American College of Rheumatology.
  
  
  METHODS
  Data from the survey were collected via Survey Monkey and data analysis was performed using the Fisher exact test and Wilcoxon rank-sum test.
  
  
  METHODS
  Response to the survey questions on primary unilateral versus bilateral biopsy, performing second-side biopsy if first side results were negative, and the duration for which biopsy findings are reliable after initiating immunosuppressive therapy.
  
  
  RESULTS
  The self-described primary subspecialty of the 1074 respondents was as follows: oculoplastic surgery (n = 127), neuro-ophthalmology (n = 119), rheumatology (n = 799), and other (n = 28). Overall, 66% of respondents advocated initial unilateral TAB, 18% advocated bilateral biopsy in all cases, and 16% recommended either unilateral or bilateral TAB depending on the degree of clinical suspicion. Rheumatologists were 4.5 times more likely to advocate initial bilateral biopsy than neuro-ophthalmologists or oculoplastic surgeons (P<0.0001, Fisher exact test). Most respondents believed that biopsy results were accurate for more than 14 days. These results were not affected by stratification of years in practice by the Kruskal-Wallis rank-sum test.
  
  
  CONCLUSIONS
  Temporal artery biopsy practices vary greatly among treating physicians. This lack of consensus underscores the need for a systematic assessment of varying practice patterns.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Schallhorn
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Haug
authors.forename: Michael K
authors.initials: MK
authors.lastname: Yoon
authors.forename: Travis
authors.initials: T
authors.lastname: Porco
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Seiff
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: McCulley
mesh_terms: D001706:Biopsy; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006306:Health Surveys; D006801:Humans; D009885:Ophthalmology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D013699:Temporal Arteries / Q000473:pathology*; D014481:United States
chemical_list: D005938:Glucocorticoids