{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:09:35Z","timestamp":1791385775045,"version":"4.3.3"},"reference-count":31,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:00:00Z","timestamp":1612396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006225","name":"Oak Ridge Associated Universities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006225","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Although tick-borne diseases account for a large number of health care visits in the United States, clinical practices for tick bite and Lyme disease treatment and prevention are not well understood. The objective of this study was to better understand factors associated with clinical practices related to tick bites and Lyme disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 2013-2015, questions about tick-bite evaluation, Lyme disease diagnosis and treatment, appropriate use of Lyme disease testing, and tick-bite prevention were included in Porter Novelli\u2019s DocStyles survey, a nationally representative annual web-based survey of health care providers. We performed analyses of responses by provider license type and state-level incidence (high or low) of Lyme disease in 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 4517 providers were surveyed across the 3 study years. Overall, 80.9% of providers reported that they had evaluated at least 1 patient for a tick bite, 47.6% had diagnosed at least 1 patient with Lyme disease, and 61.9% had treated at least 1 patient for Lyme disease in the previous year. Providers from states with a high incidence of Lyme disease saw more patients for tick bites and Lyme disease than providers from states with a low incidence of Lyme disease. Few providers correctly chose Lyme disease testing as clinically useful in the hypothetical case of a patient from a state with a high incidence of Lyme disease with an arthritic knee (36.0%) or with new-onset atrioventricular block (39.5%), and respondents across all provider types incorrectly chose testing when not clinically indicated. Most providers (69.7%) reported routinely recommending tick-bite prevention methods to patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Many providers evaluate patients for tick bites and treat patients for Lyme disease, but knowledge about appropriate testing is low. Providers may benefit from tailored education about appropriate Lyme disease diagnosis, testing, and effective tick-bite prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0033354920973235","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T03:02:57Z","timestamp":1612839777000},"page":"609-617","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Diagnosis, Treatment, and Prevention Practices for Lyme Disease by Clinicians, United States, 2013-2015"],"prefix":"10.1177","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4942-2285","authenticated-orcid":false,"given":"Alyssa R.","family":"Beck","sequence":"first","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA"},{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace E.","family":"Marx","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison F.","family":"Hinckley","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"bibr1-0033354920973235","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780200102"},{"key":"bibr2-0033354920973235","unstructured":"Centers for Disease Control and Prevention. Lyme disease (\n                      Borrelia burgdorferi\n                      ). Accessed September 18, 2019. https:\/\/wwwn.cdc.gov\/nndss\/conditions\/lyme-disease"},{"key":"bibr3-0033354920973235","unstructured":"Centers for Disease Control and Prevention. Reported cases of Lyme disease by state or locality, 2009-2018. Accessed January 8, 2020. https:\/\/www.cdc.gov\/lyme\/stats\/tables.html"},{"key":"bibr4-0033354920973235","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu397"},{"key":"bibr5-0033354920973235","doi-asserted-by":"publisher","DOI":"10.3201\/eid2109.150417"},{"key":"bibr6-0033354920973235","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6622a1"},{"key":"bibr7-0033354920973235","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2008.08.030"},{"key":"bibr8-0033354920973235","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2017.11.006"},{"issue":"31","key":"bibr9-0033354920973235","first-page":"590","volume":"44","author":"Centers for Disease Control and Prevention","year":"1995","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr10-0033354920973235","doi-asserted-by":"publisher","DOI":"10.3201\/eid2207.151694"},{"key":"bibr11-0033354920973235","doi-asserted-by":"publisher","DOI":"10.1086\/508667"},{"key":"bibr12-0033354920973235","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2012.10.008"},{"key":"bibr13-0033354920973235","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqx153"},{"key":"bibr14-0033354920973235","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.3.206"},{"issue":"5","key":"bibr15-0033354920973235","first-page":"e289","volume":"58","author":"Henry B.","year":"2012","journal-title":"Can Fam Physician"},{"issue":"4","key":"bibr16-0033354920973235","first-page":"277","volume":"15","author":"Magri JM.","year":"2002","journal-title":"J Am Board Fam Pract"},{"key":"bibr17-0033354920973235","unstructured":"Centers for Disease Control and Prevention. Ticks. Accessed September 18, 2019. https:\/\/www.cdc.gov\/ticks\/avoid\/on_people.html"},{"key":"bibr18-0033354920973235","unstructured":"SERMO. Overview. Accessed September 23, 2019. http:\/\/www.sermo.com\/overview"},{"key":"bibr19-0033354920973235","volume-title":"DocStyles 2013-15 Methodology","author":"Porter Novelli Public Services","year":"2013"},{"key":"bibr20-0033354920973235","volume-title":"DocStyles 2013-15 Methodology","author":"Porter Novelli Public Services","year":"2014"},{"key":"bibr21-0033354920973235","volume-title":"DocStyles 2013-15 Methodology","author":"Porter Novelli Public Services","year":"2015"},{"key":"bibr22-0033354920973235","unstructured":"Porter Novelli. PNSTYLES. 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