title: Physician attitude, awareness, and knowledge regarding guidelines for transcranial Doppler screening in sickle cell disease.
abstract: OBJECTIVE
  We explored factors that may influence physician adherence to transcranial Doppler (TCD) screening guidelines among children with sickle cell disease.
  
  
  METHODS
  Pediatric hematologists, neurologists, and primary care physicians (n = 706) responded to a mailed survey in May 2012 exploring factors hypothesized to influence physician adherence to TCD screening guidelines: physician (internal) barriers and physician-perceived external barriers. Responses were compared by specialty using chi-square tests.
  
  
  RESULTS
  Among 276 physicians (44%), 141 currently treated children with sickle cell disease; 72% recommend screening. Most primary care physicians (66%) did not feel well informed regarding TCD guidelines, in contrast to neurologists (25%) and hematologists (6%, P < .0001). Proportion of correct answers on knowledge questions was low (13%-35%). Distance to a vascular laboratory and low patient adherence were external barriers to receipt of TCD screening.
  
  
  CONCLUSIONS
  Additional research regarding physicians' lack of self-efficacy and knowledge of recommendations could help clarify their role in recommendation of TCD screening.
authors.affiliation: University of Michigan, Ann Arbor, MI, USA sleasure@umich.edu.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Reeves
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Fullerton
authors.affiliation: University of Michigan, Ann Arbor, MI, USA.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Dombkowski
authors.affiliation: University of Michigan, Ann Arbor, MI, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Boulton
authors.affiliation: University of Michigan, Ann Arbor, MI, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Braun
authors.affiliation: University of Michigan, Ann Arbor, MI, USA.
authors.forename: Lynda D
authors.initials: LD
authors.lastname: Lisabeth
mesh_terms: D000755:Anemia, Sickle Cell / Q000000981:diagnostic imaging*; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D017585:Ultrasonography, Doppler, Transcranial / Q000523:psychology / Q000706:statistics & numerical data*
keywords: children; guidelines; sickle cell disease; survey; transcranial Doppler ultrasonography