Lyme Disease Testing in a High-Incidence State: Clinician Knowledge and Patterns

Area of Science:

• Infectious Diseases
• Medical Diagnostics
• Public Health

Background:

• Lyme disease incidence is rising, indicating a growing public health concern.
• Clinician awareness of recommended Lyme disease diagnostic testing procedures appears inconsistent.
• There is a need to evaluate current clinical practices in high-incidence areas.

Purpose of the Study:

• To assess clinician knowledge and practices regarding Lyme disease diagnostic testing.
• To identify specific areas of misunderstanding in Lyme disease test interpretation.
• To evaluate the impact of clinician awareness on patient care in a high-incidence region.

Main Methods:

• A survey was distributed to 1,142 clinicians in the University of Vermont Medical Center region, with 144 responses (12.6% completion rate).
• Analysis included Lyme disease laboratory test results over 2.5 years and customer service call logs for 6 months.
• Data were collected to correlate clinician knowledge with actual testing practices and outcomes.

Main Results:

• While most clinicians showed basic knowledge of diagnostic protocols, a significant portion (42.4%) misinterpreted Western blot results, particularly immunoglobulin M.
• Misinterpretation was evident in cases of longstanding symptoms, where a positive IgM was incorrectly deemed an overall positive test.
• Clinicians reported frequent patient requests for unvalidated diagnostic tests, highlighting a gap in evidence-based practice.

Conclusions:

• Additional education is crucial to improve clinician understanding of Lyme disease diagnostic test interpretation.
• Modifications to test ordering and reporting systems are necessary to minimize diagnostic errors.
• Enhancing clinician knowledge and refining testing protocols can lead to improved patient care for Lyme disease.