Patterns of Lyme disease diagnosis and treatment by family physicians in a southeastern state

Area of Science:

• Infectious Diseases
• Public Health Surveillance
• Clinical Diagnostics

Background:

• Lyme disease diagnosis and treatment practices among primary care physicians can vary.
• Accurate diagnosis is crucial for effective patient management and understanding disease prevalence.
• Georgia's reported Lyme disease incidence is historically low, prompting investigation into physician diagnostic patterns.

Purpose of the Study:

• To assess the frequency of Lyme disease diagnosis and treatment by family physicians in Georgia.
• To identify the diagnostic criteria utilized by these physicians.
• To compare physician-reported Lyme disease diagnoses with official surveillance data.

Main Methods:

• A survey was distributed to 1,331 family physicians in Georgia.
• Physicians were queried about the number of Lyme disease cases diagnosed and treated in the past 12 months.
• Information on diagnostic criteria, including serologic testing, was collected.

Main Results:

• Out of 710 respondents, 167 physicians treated 316 Lyme disease cases without a definitive diagnosis.
• 125 physicians diagnosed 262 cases, with 130 lacking serologic confirmation and 132 utilizing it.
• Physician-diagnosed Lyme disease rates in Georgia were found to be approximately 40 times higher than reported surveillance case rates.

Conclusions:

• Family physicians in Georgia diagnose Lyme disease at a substantially higher rate than indicated by public health surveillance.
• A significant proportion of diagnosed Lyme disease cases were treated without confirmed diagnostic criteria or serologic evidence.
• These findings suggest a potential discrepancy between clinical practice and surveillance data for Lyme disease in Georgia, warranting further investigation into diagnostic practices and reporting.