Infectious disease telephone consultations: Numerous, varied and an important educational resource

Duncan, Cameron; Gallacher, Katie; Kennedy, D.H.; Fox, R.; Seaton, R.A.; MacConnachie, A

doi:10.1016/j.jinf.2006.08.014

Cited by 11 publications

(4 citation statements)

References 6 publications

(3 reference statements)

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“…However in agreement with our data several instances of misclassification of P. falciparum 4,5 and other serious illnesses 9 have been reported in the context of protocol-based case-definitions during the peak of community transmission during the pandemic, highlighting the limitations of such protocol or algorithm-based diagnosis 5 . Telephone consultation is an important component of infectious disease practice, 13 and telephone or internet-based triage has considerable practical advantages in pandemic settings, however the poor predictive capacity of the pandemic case-definition demonstrated here supports the revisions to the case definition to incorporate travel history 3 …”

Section: Discussionsupporting

confidence: 90%

Distinguishing malaria and influenza: Early clinical features in controlled human experimental infection studies

Lillie

Duncan

Sheehy

et al. 2012

Travel Medicine and Infectious Disease

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SummaryDuring the H1N1 influenza pandemic (pH1N1/09) diagnostic algorithms were developed to guide antiviral provision. However febrile illnesses are notoriously difficult to distinguish clinically. Recent evidence highlights the importance of incorporating travel history into diagnostic algorithms to prevent the catastrophic misdiagnosis of life-threatening infections such as malaria.We applied retrospectively the UK pH1N1/09 case definition to a unique cohort of healthy adult volunteers exposed to Plasmodium falciparum malaria or influenza to assess the predictive value of this case definition, and to explore the distinguishing clinical features of early phase infection with these pathogens under experimental conditions.For influenza exposure the positive predictive value of the pH1N1/09 case definition was only 0.38 (95% CI: 0.06–0.60), with a negative predictive value of 0.27 (95% CI: 0.02–0.51). Interestingly, 8/11 symptomatic malaria-infected adults would have been inappropriately classified with influenza by the pH1N1/09 case definition, while 5/8 symptomatic influenza-exposed volunteers would have been classified without influenza (P = 0.18 Fisher's exact). Cough (P = 0.005) and nasal symptoms (P = 0.001) were the only clinical features that distinguished influenza-exposed from malaria-exposed volunteers.An open mind regarding the clinical cause of undifferentiated febrile illness, particularly in the absence of upper respiratory tract symptoms, remains important even during influenza pandemic settings. These data support incorporating travel history into pandemic algorithms.

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Section: Discussionsupporting

confidence: 90%

Distinguishing malaria and influenza: Early clinical features in controlled human experimental infection studies

Lillie

Duncan

Sheehy

et al. 2012

Travel Medicine and Infectious Disease

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“…Informal consultations accounted for 73% of HIDC activity, consistent with previous studies [1,17,18]. They provide rapid answers and replace certain formal consultations and hospitalizations [19].…”

Section: Discussionsupporting

confidence: 86%

“…Access to the expertise of infectious disease specialists (IDSs) by non-ID physicians managing patients with IDs is an ongoing challenge reflected by high numbers of solicitations in different settings [1][2][3]. In 2000, a hotline for ID consultation (HIDC) was created at Grenoble university-affiliated hospital (GUH), aiming to respond to increasing requests from non-ID physicians.…”

Section: Introductionmentioning

confidence: 99%

Prospective study of telephone calls to a hotline for infectious disease consultation: analysis of 7,863 solicited consultations over a 1-year period

Gennai

François

Sellier

et al. 2010

Eur J Clin Microbiol Infect Dis

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PurposeTo respond to the increasing requests of noninfectious disease physicians for access to infectious diseases expertise, a hotline was created in the infectious diseases consultation (IDC) unit of the Grenoble university-affiliated hospital (GUH). This study describes the patterns of solicited consultations provided by the hotline during a 1-year period. MethodsWe conducted a prospective study of consecutive solicited IDCs requested by physicians in 2008. ResultsA total of 7,863 consultations were requested by physicians over 1 year; 4,407 (56.0%) by ambulatory physicians, 2,933 (37.3%) by GUH physicians, and 523 (6.7%) by physicians in public or private hospitals. The majority of consultations were requested via cell phone (58.7%). The main reasons for requesting a consultation were related to antimicrobial treatment for hospital-based physicians and prophylaxis for ambulatory physicians (p<0.001).Recommendations to perform diagnostic or monitoring tests were less frequent in ambulatory medicine (16%) than in the GUH (59%) or other hospitals (63%, p<0.001). The route of consultation for patients with nosocomial infections was more likely to be formal (p<0.001). ConclusionsThe activity of the IDC hotline attests to an important need for such expertise consultation, both in hospitals and ambulatory medicine.

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“…Solicited consultations are part of the everyday practice and a substantial part of ID specialists' workload in hospitals [2,11]. The most frequent purposes of requests are related to therapeutic and diagnostic recommendations.…”

Section: Introductionmentioning

confidence: 99%

Requesting physicians' experiences regarding infectious disease consultations

et al. 2011

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BackgroundSolicited consultations constitute a substantial workload for infectious disease (ID) specialists in the hospital setting. The objectives of this survey were to describe requesting physicians' experiences regarding ID consultations.MethodsA cross-sectional survey was conducted in a university-affiliated hospital in France in 2009. All physicians were eligible (n = 530) and received a self-administered questionnaire. The main outcomes were reasons for request and opinion. Secondary outcomes were frequency of request and declared adherence to recommendations.ResultsThe participation rate was 44.7% (237/530). Among the responders, 187 (79%) had solicited the ID consultation service within the previous year. Ninety-three percent of the responders (173/187) were satisfied with the ID consultation. The main reasons for requesting consultations were the need for therapeutic advice (93%), quality of care improvement (73%) and the rapidity of access (61%). ID consultations were requested several times a month by 52% (72/138) of senior physicians and by 73% (36/49) of residents (p = 0.01). Self-reported adherence to diagnostic and therapeutic recommendations was 83% and 79%, respectively.ConclusionThe respondent requesting physicians expressed great satisfaction regarding ID consultations that they requested principally to improve patient care and to assist in medical decision making.

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Infectious disease telephone consultations: Numerous, varied and an important educational resource

Cited by 11 publications

References 6 publications

Distinguishing malaria and influenza: Early clinical features in controlled human experimental infection studies

Distinguishing malaria and influenza: Early clinical features in controlled human experimental infection studies

Prospective study of telephone calls to a hotline for infectious disease consultation: analysis of 7,863 solicited consultations over a 1-year period

Requesting physicians' experiences regarding infectious disease consultations

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