Post by Admin/ Traveler on Aug 3, 2019 20:56:23 GMT
Misdiagnosis of Lyme Disease With Unnecessary Antimicrobial Treatment Characterizes Patients Referred to an Academic Infectious Diseases Clinic
Takaaki Kobayashi, Yvonne Higgins, Roger Samuels, Aurasch Moaven, Abanti Sanyal, Gayane Yenokyan, Paul M Lantos, Michael T Melia, Paul G Auwaerter (Trav here )
Open Forum Infectious Diseases, Volume 6, Issue 7, July 2019, ofz299, doi.org/10.1093/ofid/ofz299
Published: 05 July 2019
Abstract
Background
Although Lyme disease is the most common vector-borne infection in the United States, diagnostic accuracy within community settings is not well characterized.
Methods
A retrospective observational cohort study of patients referred to an academic center with a presumed diagnosis or concern for Lyme disease between 2000 and 2013 was performed to analyze diagnoses and treatments. Characteristics of those with Lyme disease and those misdiagnosed as having Lyme disease were compared.
Results
Of 1261 patients, 911 (72.2%) did not have Lyme disease, 184 (14.6%) had active or recent Lyme disease, 150 (11.9%) had a remote history of Lyme disease, and 16 (1.3%) were identified as having possible Lyme disease. Patients without current Lyme disease were more likely to be female (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.08–2.45), to have had symptoms for >3 months (OR, 8.78; 95% CI, 5.87–13.1), to have higher symptom counts (OR per additional symptom, 1.08; 95% CI, 1.02–1.13), to have had more Lyme-related laboratory testing (OR per additional laboratory test, 1.17; 95% CI, 1.03–1.32), and to have been diagnosed with what were regarded as coinfections (OR, 3.13; 95% CI, 1.14–8.57). Of the 911 patients without Lyme disease, 764 (83.9%) had received antimicrobials to treat Lyme disease or their coinfections. The percentage of patients established to have Lyme disease was lower than in earlier studies of referred populations.
Conclusions
Among patients referred to an academic Infectious Diseases practice for Lyme disease, incorrect diagnoses and unnecessary antibiotic treatment were common, both for Lyme disease and for coinfections.
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Trav here - the link will take you to the full article, but I just couldn't bring myself to read or post the entire thing. Their reasonings just make me ill.
So, how is this relevant to us? First and foremost, remember, they are applying THEIR standards to Lyme patients. We all know that their 'preferred testing' will miss most early Lyme cases, and most of the late Lyme cases. So, right there, they (the researchers) should be thrown out on their tails for not being upfront about their obvious biases - but I digress (some).
And of course, women are blamed. Why? Because many doctors STILL believe in "female hysteria", in that we women will always make something out of nothing. Talk about biases! But, there is some scientific reasons for women to be more affected - but that's another subject, and one that the above authors would never recognize anyway.
This is just disgusting to me. I don't know why this man (Auwaeter) still has a job anywhere in science, other than as a janitor.
Takaaki Kobayashi, Yvonne Higgins, Roger Samuels, Aurasch Moaven, Abanti Sanyal, Gayane Yenokyan, Paul M Lantos, Michael T Melia, Paul G Auwaerter (Trav here )
Open Forum Infectious Diseases, Volume 6, Issue 7, July 2019, ofz299, doi.org/10.1093/ofid/ofz299
Published: 05 July 2019
Abstract
Background
Although Lyme disease is the most common vector-borne infection in the United States, diagnostic accuracy within community settings is not well characterized.
Methods
A retrospective observational cohort study of patients referred to an academic center with a presumed diagnosis or concern for Lyme disease between 2000 and 2013 was performed to analyze diagnoses and treatments. Characteristics of those with Lyme disease and those misdiagnosed as having Lyme disease were compared.
Results
Of 1261 patients, 911 (72.2%) did not have Lyme disease, 184 (14.6%) had active or recent Lyme disease, 150 (11.9%) had a remote history of Lyme disease, and 16 (1.3%) were identified as having possible Lyme disease. Patients without current Lyme disease were more likely to be female (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.08–2.45), to have had symptoms for >3 months (OR, 8.78; 95% CI, 5.87–13.1), to have higher symptom counts (OR per additional symptom, 1.08; 95% CI, 1.02–1.13), to have had more Lyme-related laboratory testing (OR per additional laboratory test, 1.17; 95% CI, 1.03–1.32), and to have been diagnosed with what were regarded as coinfections (OR, 3.13; 95% CI, 1.14–8.57). Of the 911 patients without Lyme disease, 764 (83.9%) had received antimicrobials to treat Lyme disease or their coinfections. The percentage of patients established to have Lyme disease was lower than in earlier studies of referred populations.
Conclusions
Among patients referred to an academic Infectious Diseases practice for Lyme disease, incorrect diagnoses and unnecessary antibiotic treatment were common, both for Lyme disease and for coinfections.
-----------------------------------------------------------------------------------------------------------------------
Trav here - the link will take you to the full article, but I just couldn't bring myself to read or post the entire thing. Their reasonings just make me ill.
So, how is this relevant to us? First and foremost, remember, they are applying THEIR standards to Lyme patients. We all know that their 'preferred testing' will miss most early Lyme cases, and most of the late Lyme cases. So, right there, they (the researchers) should be thrown out on their tails for not being upfront about their obvious biases - but I digress (some).
And of course, women are blamed. Why? Because many doctors STILL believe in "female hysteria", in that we women will always make something out of nothing. Talk about biases! But, there is some scientific reasons for women to be more affected - but that's another subject, and one that the above authors would never recognize anyway.
This is just disgusting to me. I don't know why this man (Auwaeter) still has a job anywhere in science, other than as a janitor.