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Take the guesswork out of ordering labs for infectious diseases :

June 27, 2019

Editor's note:The 2019 AAP National Conference & Exhibition will take place from Oct. 25-29 in New Orleans.

Gary S. Marshall, M.D., FAAP, will present “To Order or Not? Appropriate Use of Infectious Disease Labs” on Saturday, Oct. 26 from 7:30-8:15 a.m. (F2013) in rooms 220-222 in the convention center and again from 3-3:45 p.m. (F2196) in rooms 225-227.

Dr. Marshall is a member of the AAP Section on Infectious Diseases and professor of pediatrics and chief of the Division of Pediatric Infectious Diseases at the University of Louisville School of Medicine.

In the following Q&A, Dr. Marshall summarizes what he plans to discuss during the session and why pediatricians should attend.

Q: What are the key things you will be covering during the session?

A: A plethora of diagnostic tests for infectious diseases are just a click away. Methods for detecting organisms run the gamut from culture to genomic amplification; methods for detecting the host response to infection range from specific antibody assays to measurement of in-vitro lymphocyte activation. Panels that allow for diagnosis of multiple infections using a single specimen have become popular. Despite these technological advances, our ability to diagnose infections accurately is only as good as the decision-making that precedes the click and the critical thinking that follows knowledge of the result.

Q: Why is this an important topic for pediatricians to learn more about?

A: Diagnostic errors that arise from ordering the wrong test or misinterpreting test results can lead, at best, to inappropriate treatment, and, at worst, to hiding the real problem.

Q: How did you get interested in appropriate use of infectious disease labs?

A: I started keeping a mental list of patients who were referred for diagnoses that were based on misinterpreted test results or tests that shouldn’t have been done in the first place. Examples include recurrent streptococcal pharyngitis in the school-aged child with viral infections; chronic Epstein-Barr virus in the lazy teenager; Lyme disease in the Kentucky kid who had an attached tick; recurrent Clostridium difficile colitis in the 10-month-old.

Q: What is the take-home message of the session?

A: Be a good Bayesian.

For more coverage of the 2019 AAP National Conference & Exhibition, visit http://bit.ly/AAPNationalConference19.

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