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Practice-based research networks can use E-mail to speed diagnosis of anthrax and other rare infectious diseases

Rapid detection of illnesses due to bioterrorism such as inhalational anthrax and emerging infections such as severe acute respiratory syndrome (SARS) can be aided by use of E-mail surveillance within practice-based research networks (PBRNs), according to a recent study supported in part by the Agency for Healthcare Research and Quality (HS13494). An E-mail to physicians in a PBRN substantially reduced the time to diagnosis of hypothetical cases of infectious disease.

A speedy response is critical in disease outbreaks that demand quick diagnosis and action, note University of Wisconsin researchers, Jonathan L. Temte, M.D., Ph.D., and Anna Lisa Anderson, B.S. They compared responses to a mailed survey from a nationwide random sample of family physicians with responses to an E-mail to 55 physician members of the Wisconsin Research Network (WreN), a regional PBRN. The survey consisted of three case vignettes randomly drawn from a set describing 11 patients with inhalational anthrax, 2 with influenza A, and 1 with Legionella pneumonia. Physicians responded to four yes-or-no case management questions for each case.

Response rates were similar for the two groups, but PBRN E-mail substantially reduced the median response time (from 28 days for mailed surveys to 2 days for the E-mail group). There were no differences in case diagnoses or case management between the two groups of physicians, and the initial management of the hypothetical inhalational anthrax cases was quite good. The authors conclude that electronic means of diagnosing rare infectious diseases of national significance is feasible within PBRNs.

See "Rapid assessment of agents of biological terrorism: Defining the differential diagnosis of inhalational anthrax using electronic communication in a practice-based research network," by Dr. Temte and Ms. Anderson, in the September 2004 Annals of Family Medicine 2(5), pp. 434-437.

Editor's Note: Another AHRQ-supported study on a related topic provides an overview of existing infectious disease surveillance systems and how they interact to detect disease outbreaks. For more details, see Dato, V., Wagner, M. M., and Fapohunda, A. (2004, September). "How outbreaks of infectious disease are detected: A review of surveillance systems and outbreaks." (AHRQ contract 290-00-0009). Public Health Reports 119, pp. 464-471.

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