IMPACT OF MEDIAL SPECIALTY ON THE APPROACH TO AIDS PATIENTS WITH INTRACRANIAL MASS LESIONS (MEETING ABSTRACT)

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

IMPACT OF MEDIAL SPECIALTY ON THE APPROACH TO AIDS PATIENTS WITH INTRACRANIAL MASS LESIONS (MEETING ABSTRACT)

Proc Annu Meet Am Soc Clin Oncol; 11:A4 1992. Unique Identifier : AIDSLINE ICDB/92680735
Corn B; Trock B; Univ. of Pennsylvania, Philadelphia, PA

Abstract: This study was designed to assess the management of intracranial mass lesions in AIDS patients (pts). Surveys were mailed to a random sample of 800 neurosurgeons (NS), radiation oncologists (RO), neurologists (N), and infectious disease experts (ID). The survey described an hypothetical AIDS pt with an unbiopsied intracranial mass. Approx 50% of the surveys were returned. Response rate did not differ by specialty. Over 60% of all physicians, irrespective of specialty, would empirically treat the pt for toxoplasmosis. When asked whether biopsy would be pursued if the pt did not respond to such empiric therapy, 37% of NS responded negatively in comparison to 17% of RO, 7% of N, 4% of ID (p less than 0.001). When asked to express their misgivings regarding biopsy, 48% of NS indicated that risks to the operating team were a major concern in comparison to 17% of RO, 23% of N, 3% of ID (p less than 0.001). Biopsy was deemed a 'major waste of medical resources' by 50% of NS, 11% of RO, 13% of N, 9% of ID (p less than 0.001). These trends were not influenced by type of practice (academic/nonacademic) or year of completion of residency training (pre-/post-AIDS era). Our report reveals a significant lack of uniformity among physician specialists in their approach to AIDS pts with unbiopsied brain lesions. These findings may have implications for the care of such pts until the risks of biopsy and the efficacy of therapeutic interventions can be defined.

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/*THERAPY Biopsy Brain Diseases/*ETIOLOGY/PATHOLOGY/*THERAPY Brain Neoplasms/*ETIOLOGY/PATHOLOGY/*THERAPY Communicable Diseases/*THERAPY Comparative Study Human Medical Oncology Neurology Neurosurgery Questionnaires Radiology *Specialties, Medical Toxoplasmosis/ETIOLOGY/*THERAPY ABSTRACT

921130
M92B0904

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