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Volume 10, Number 9—September 2004

Dispatch

Barriers to Creutzfeldt-Jakob Disease Autopsies, California

Janice K. Louie*†Comments to Author , Shilpa S. Gavali*, Ermias D. Belay‡, Rosalie Trevejo†, Lucinda H. Hammond*, Lawrence B. Schonberger‡, and Duc J. Vugia*†
Author affiliations: *California Emerging Infections Program, Richmond, California, USA; †California Department of Health Services, Berkeley, California, USA; ‡Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Table 1

Knowledge and experience of California neurologists, pathologists, and neuropathologists in diagnosing Creutzfeldt-Jakob disease (CJD)

Characteristic Neurologists 
n/N (%) Pathologists 
n/N (%) Neuropathologists 
n/N (%)
Have evaluated a case of CJD 212/310 (68) 56/259 (22) 18/33 (55)
Median no. (range) of CJD cases evaluated 3 (0–30) 2 (0–30) 10 (0–50)
Type of practice
  Private practice/private hospital 144/308 (47) 122/278 (44) 8/33 (25)
  Outpatient HMOa/managed care 55/308 (18)
  Community hospital/clinic 1/308 (<1) 68/278 (24) 4/33 (12)
  University affiliated 82/308 (27) 37/278 (13) 10/33 (30)
  Veterans hospital 13/308 (4) 3/278 (1) 1/33 (3)
  County medical examiner or coroner 7/278 (3) 2/33 (6)
  Other 15/308 (5) 41/278 (15) 5/33 (15)
Can recognize the clinical or pathologic features of classic CJD 255/307 (83) 96/273 (35) 25/28 (89)
Can recognize the clinical or pathologic features of variant CJD 120/305 (39) 40/274 (15) 18/28 (64)
Have not considered arranging for an autopsy for CJD patients under their care 74/207 (36)
Pathology group available at facility to perform autopsy on suspect CJD cases 223/297 (75) 74/259 (29) 17/28 (61)
Pathology group available at facility to confirm diagnosis of suspect CJD with histopathologic analysis 223/297 (75) 91/254 (36) 18/27 (67)

aHMO, health maintenance organization.

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