Physician Diagnostic and Reporting Practices for Gastrointestinal Illnesses in Three Health Regions of British Columbia

Abstract

Objectives: To estimate seasonal proportions of patient visits due to acute gastrointestinal illness (GI), assess factors influencing physicians' stool sample requests, their understanding of laboratory testing protocols and adherence to provincial stool request guidelines in three British Columbia (BC) health regions. Methods: During a one-year period, eligible physicians were mailed four self-administered questionnaires used to estimate proportions of patients diagnosed with GI, related stool sample requests in the preceding month, and to assess factors prompting stool sample requests. Results: The response rate overall for the initial comprehensive questionnaire was 18.6%; 7.4% responded to all four questionnaires. An estimated 2.5% of patient visits had a GI diagnosis; of these, 24.8% were asked to submit stool samples. Significant (p<0.05) regional and seasonal variations were found in rates of GI and stool sample requests. Topranked factors prompting stool sample requests were: bloody diarrhoea, recent overseas travel, immunocompromised status, and duration of illness >7 days; "non-patient" factors included: laboratory availability, time to receive laboratory results, and cost. Physicians' perceptions of which organisms were tested for in a 'routine' stool culture varied. Interpretation: BC physicians appear to adhere to existing standardized guidelines for sample requests. This may result in systematic under-representation of certain diseases in reportable communicable disease statistics. MeSH terms: Gastrointestinal diseases; physician practices; gastroenteritis; infectious disease reporting; surveillance La traduction du résumé se trouve à la fin de l'article.

Physician practices in requesting stool samples for patients with acute gastroenteritis, France, August 2013–July 2014

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The Incidence of Acute Gastrointestinal Illness in Canada, Foodbook Survey 2014-2015

“…The exclusion of individuals who travelled in the past seven days in the Foodbook study may also influence the lower results. Recent travel is associated with seeking medical care and having a sample requested [ 42 , 43 ]; thus, these individuals who travelled may have been more likely to seek care and be requested to submit a stool sample. Lower care seeking rates would influence pathogen-specific estimates as it indicates greater underdiagnosis of cases.…”

Long-Term Sentinel Surveillance for Enterotoxigenic Escherichia coli and Non-O157 Shiga Toxin-Producing E. coli in Minnesota

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