Volume 10, Number 9—September 2004
Dispatch
Barriers to Creutzfeldt-Jakob Disease Autopsies, California
Janice K. Louie*†
, Shilpa S. Gavali*, Ermias D. Belay‡, Rosalie Trevejo†, Lucinda H. Hammond*, Lawrence B. Schonberger‡, and Duc J. Vugia*†
, Shilpa S. Gavali*, Ermias D. Belay‡, Rosalie Trevejo†, Lucinda H. Hammond*, Lawrence B. Schonberger‡, and Duc J. Vugia*†
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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