Lyme disease overdiagnosis in a large healthcare system: a population-based, retrospective study

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
B J WebberK J Gambino-Shirley

Abstract

To evaluate the impact of false-positive IgM immunoblots on Lyme disease treatment and case reporting in a large healthcare system. We obtained the results of all Lyme disease serological tests ordered at U.S. Air Force healthcare facilities in the USA between January 2013 and December 2017. We conducted chart reviews to adjudicate positive IgM immunoblots (from two-tier and independent testing) as true positives or false positives using established criteria, and we assessed whether these cases were reported to the U.S. Department of Defense surveillance system. Of the 18 410 serum tests (17 058 immunoassays and 1352 immunoblots) performed on 15 928 unique individuals, 249/1352 (18.4%) IgM immunoblots were positive. After excluding repeat tests, insufficiently documented cases, and participants with a history of Lyme disease, 212 positive IgM immunoblot cases were assessed. A total of 113/212 (53.3%) were determined to be false positives. Antibiotics were prescribed for Lyme disease for 97/99 (98.0%) participants with a true-positive test and 91/113 (80.5%) participants with a false-positive test. The number of false-positive cases reported to the surveillance system was identical to the number of unreported true-positive cases...Continue Reading

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Mar 7, 2020·Current Opinion in Rheumatology·Robert T Schoen
Jan 9, 2020·Current Rheumatology Reports·Robert T Schoen
Jun 9, 2020·Frontiers in Cellular and Infection Microbiology·Emilie Talagrand-ReboulCarole Eldin
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Jan 29, 2022·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Greg JoynerChin Lim

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