       Document 0303
 DOCN  M9610303
 TI    Ability of primary care physicians to recognize physical findings
       associated with HIV infection.
 DT    9601
 AU    Paauw DS; Wenrich MD; Curtis JR; Carline JD; Ramsey PG; Department of
       Medicine, University of Washington School of; Medicine, Seattle, USA.
 SO    JAMA. 1995 Nov 1;274(17):1380-2. Unique Identifier : AIDSLINE
       MED/96042066
 AB    OBJECTIVE--To assess the ability of primary care physicians to identify
       physical findings associated with human immunodeficiency virus (HIV)
       infection. DESIGN--Standardized patient examination. PARTICIPANTS--A
       total of 134 general internists and family practitioners were randomly
       selected after stratifying by year of medical school graduation,
       specialty, and experience caring for patients with HIV infection. MAIN
       OUTCOME MEASURES--Recognition of physical findings of Kaposi's sarcoma,
       oral hairy leukoplakia, and diffuse lymphadenopathy. RESULTS--Despite
       being directed by presenting histories to sites of prominent physical
       abnormalities, only 23 (25.8%) of 89 physicians evaluating a patient
       with Kaposi's sarcoma and 22 (22.7%) of 97 physicians evaluating a
       patient with oral hairy leukoplakia detected and correctly diagnosed the
       abnormalities. Twenty-three (17%) of 133 physicians detected diffuse
       lymphadenopathy in a patient complaining of fatigue, fever, and
       arthralgias. Physicians with the most experience treating patients with
       HIV infection more frequently identified oral hairy leukoplakia, but HIV
       experience did not influence identification of Kaposi's sarcoma or
       detection of lymphadenopathy. There were no differences between general
       internists and family practitioners or among physicians by year of
       medical school graduation in identifying the three physical findings
       associated with HIV infection. CONCLUSIONS--Primary care physicians may
       frequently miss important physical findings related to HIV infection
       during patient examinations.
 DE    *Clinical Competence/STATISTICS & NUMER DATA  *Family
       Practice/STATISTICS & NUMER DATA  Human  HIV
       Infections/COMPLICATIONS/*DIAGNOSIS  Leukoplakia,
       Hairy/DIAGNOSIS/ETIOLOGY  Linear Models  Lymphatic
       Diseases/DIAGNOSIS/ETIOLOGY  Physicians, Family/STATISTICS & NUMER DATA
       Sarcoma, Kaposi's/DIAGNOSIS/ETIOLOGY  Schools, Medical/STATISTICS &
       NUMER DATA  Support, U.S. Gov't, P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

