Ability of physicians to diagnose and manage illness due to category a bioterrorism agents

Sara E. Cosgrove, Trish M. Perl, Xiaoyan Song, Stephen D. Sisson

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Early recognition of a terrorist attack with biologic agents will rely on physician diagnosis. Physicians' ability to diagnose and care for patients presenting after a bioterror event is unknown. The role of online casebased didactics to measure and improve knowledge in the diagnosis and treatment of these patients is unknown. Methods: A multicenter online educational intervention was completed by 631 physicians at 30 internal medicine residency programs in 16 states and Washington, DC, between July 1, 2003, and June 10, 2004. Participants completed a pretest, assessing ability to diagnose and manage potential cases of smallpox, anthrax, botulism, and plague. A didactic module reviewing diagnosis and management of these diseases was then completed, followed by a posttest. Pretest performance measured baseline knowledge. Post-test performance compared with pretest performance measured effectiveness of the educational intervention. Results were compared based on year of training and geographic location of the residency program. Results: Correct diagnoses of diseases due to bioterrorism agents were as follows: smallpox, 50.7%; anthrax, 70.5%; botulism, 49.6%; and plague, 16.3% (average, 46.8%). Correct diagnosis averaged 79.0% after completing the didactic module (P<.001). Correct management of smallpox was 14.6%; anthrax, 17.0%; botulism, 60.2%; and plague, 9.7% (average, 25.4%). Correct management averaged 79.1% after completing the didactic module (P<.001). Performance did not differ based on year of training (P=.54) or geographic location (P=.64). Attending physicians performed better than residents (P<.001). Conclusions: Physician diagnosis and management of diseases caused by bioterrorism agents is poor. An online didactic module may improve diagnosis and management of diseases caused by these agents.

Original languageEnglish (US)
Pages (from-to)2002-2006
Number of pages5
JournalArchives of Internal Medicine
Volume165
Issue number17
DOIs
StatePublished - Sep 26 2005

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Biological Warfare Agents
Physicians
Botulism
Anthrax
Smallpox
Plague
Disease Management
Geographic Locations
Internship and Residency
Biological Factors
Internal Medicine
Patient Care

ASJC Scopus subject areas

  • Internal Medicine

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Ability of physicians to diagnose and manage illness due to category a bioterrorism agents. / Cosgrove, Sara E.; Perl, Trish M.; Song, Xiaoyan; Sisson, Stephen D.

In: Archives of Internal Medicine, Vol. 165, No. 17, 26.09.2005, p. 2002-2006.

Research output: Contribution to journalArticle

Cosgrove, Sara E. ; Perl, Trish M. ; Song, Xiaoyan ; Sisson, Stephen D. / Ability of physicians to diagnose and manage illness due to category a bioterrorism agents. In: Archives of Internal Medicine. 2005 ; Vol. 165, No. 17. pp. 2002-2006.
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abstract = "Background: Early recognition of a terrorist attack with biologic agents will rely on physician diagnosis. Physicians' ability to diagnose and care for patients presenting after a bioterror event is unknown. The role of online casebased didactics to measure and improve knowledge in the diagnosis and treatment of these patients is unknown. Methods: A multicenter online educational intervention was completed by 631 physicians at 30 internal medicine residency programs in 16 states and Washington, DC, between July 1, 2003, and June 10, 2004. Participants completed a pretest, assessing ability to diagnose and manage potential cases of smallpox, anthrax, botulism, and plague. A didactic module reviewing diagnosis and management of these diseases was then completed, followed by a posttest. Pretest performance measured baseline knowledge. Post-test performance compared with pretest performance measured effectiveness of the educational intervention. Results were compared based on year of training and geographic location of the residency program. Results: Correct diagnoses of diseases due to bioterrorism agents were as follows: smallpox, 50.7{\%}; anthrax, 70.5{\%}; botulism, 49.6{\%}; and plague, 16.3{\%} (average, 46.8{\%}). Correct diagnosis averaged 79.0{\%} after completing the didactic module (P<.001). Correct management of smallpox was 14.6{\%}; anthrax, 17.0{\%}; botulism, 60.2{\%}; and plague, 9.7{\%} (average, 25.4{\%}). Correct management averaged 79.1{\%} after completing the didactic module (P<.001). Performance did not differ based on year of training (P=.54) or geographic location (P=.64). Attending physicians performed better than residents (P<.001). Conclusions: Physician diagnosis and management of diseases caused by bioterrorism agents is poor. An online didactic module may improve diagnosis and management of diseases caused by these agents.",
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