{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T14:47:56Z","timestamp":1778510876559,"version":"3.51.4"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Lyme disease (LD), caused by the bacterium Borrelia burgdorferi, is transmitted to humans in California through the bite of infected blacklegged ticks (Ixodes pacificus). Overall, the incidence of LD in California is low: approximately 0.2 confirmed cases per 100,000 population. However, California\u2019s unique ecological diversity results in wide variation in local risk, including regions with local foci at elevated risk of human disease. The diagnosis of LD can be challenging in California because the prior probability of infection for individual patients is generally low. Combined with nonspecific symptoms and complicated laboratory testing, California physicians need a high level of awareness of LD in California to recognize and diagnose LD efficiently. This research addresses an under-studied area of physicians\u2019 knowledge and practice of the testing and treatment of LD in a low-incidence state. We assessed knowledge and practices related to LD diagnosis using an electronic survey distributed to physicians practicing in California through mixed sampling methods. Overall, responding physicians in California had a general awareness of Lyme disease and were knowledgeable regarding diagnosis and treatment. However, we found that physicians in California could benefit from further education to improve test-ordering practices, test interpretation, and awareness of California\u2019s disease ecology with elevated levels of focal endemicity, to improve recognition, diagnosis, and treatment of LD in California patients.<\/jats:p>","DOI":"10.1093\/jme\/tjac137","type":"journal-article","created":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T20:06:33Z","timestamp":1663790793000},"page":"2182-2188","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of Physician Knowledge, Attitudes, and Practice for Lyme Disease in a Low-Incidence State"],"prefix":"10.1093","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7905-7592","authenticated-orcid":false,"given":"Sharon I","family":"Brummitt","sequence":"first","affiliation":[{"name":"Department of Medicine and Epidemiology, School of Veterinary Medicine, One Shields Avenue, University of California Davis , Davis, CA 95616 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle J","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, School of Medicine, Medical Sciences 1C, One Shields Avenue, University of California Davis , Davis, CA 95616 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woutrina A","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Medicine and Epidemiology, School of Veterinary Medicine, One Shields Avenue, University of California Davis , Davis, CA 95616 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7941-346X","authenticated-orcid":false,"given":"Christopher M","family":"Barker","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, One Shields Avenue, University of California Davis , Davis, CA 95616 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5788-7621","authenticated-orcid":false,"given":"Anne M","family":"Kjemtrup","sequence":"additional","affiliation":[{"name":"California Department of Public Health, Vector-Borne Disease Section , 1616 Capitol Avenue, MS 7307, P.O. Box 997377, Sacramento, CA 95899 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"2022111613200812900_CIT0001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/jcm.34.1.1-9.1996","article-title":"Evolution of the serologic response to Borrelia burgdorferi in treated patients with culture-confirmed erythema migrans","volume":"34","author":"Aguero-Rosenfeld","year":"1996","journal-title":"J. Clin. 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