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Knowledge-Based Patient Screening for Rare and Emerging Infectious/Parasitic Diseases: A Case Study of Brucellosis and Murine Typhus

1997; Centers for Disease Control and Prevention; Volume: 3; Issue: 1 Linguagem: Inglês

10.3201/eid0301.970111

1080-6059

Craig N. Carter, N. C. Ronald, James H. Steele, Ed Young, Jeffery P. Taylor, Leon H. Russell, Anne Eugster, Jessica E. West,

Brucella: diagnosis, epidemiology, treatment

Many infectious and parasitic diseases, especially those newly emerging or reemerging, present a difficult diagnostic challenge because of their obscurity and low incidence. Important clues that could lead to an initial diagnosis are often overlooked, misinterpreted, not linked to a disease, or disregarded. We constructed a computer-based decision support system containing 223 infectious and parasitic diseases and used it to conduct a historical intervention study based on field investigation records of 200 cases of human brucellosis and 96 cases of murine typhus that occurred in Texas from 1980 through 1989. Knowledge-based screening showed that the average number of days from the initial patient visit to the time of correct diagnosis was significantly reduced (brucellosis-from 17.9 to 4.5 days, p = 0.0001, murine typhus-from 11.5 to 8.6 days, p = 0.001). This study demonstrates the potential value of knowledge-based patient screening for rare infectious and parasitic diseases.