Analysis of panel physician inquiries to U.S. TB Centers of Excellence, 2018–2022
BACKGROUND: Applicants seeking entry into the United States are examined overseas for TB by panel physicians and international immigration clinicians guided by Centers for Disease Control and Prevention (CDC) TB Technical Instructions. To support this effort, CDC-funded TB Centers of Excellence (COE...
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International Union Against Tuberculosis and Lung Disease (The Union)
2024-11-01
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| Series: | IJTLD Open |
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| author | E. Leithead IV S. Subramanian K. Pimenta N.D. Goswami A. Patrawalla A. Lardizabal C. Haley L. Chen L. Armitige B. Seaworth B. Sylvester R. Bhavaraju |
| author_facet | E. Leithead IV S. Subramanian K. Pimenta N.D. Goswami A. Patrawalla A. Lardizabal C. Haley L. Chen L. Armitige B. Seaworth B. Sylvester R. Bhavaraju |
| author_sort | E. Leithead IV |
| collection | DOAJ |
| description | BACKGROUND: Applicants seeking entry into the United States are examined overseas for TB by panel physicians and international immigration clinicians guided by Centers for Disease Control and Prevention (CDC) TB Technical Instructions. To support this effort, CDC-funded TB Centers of Excellence (COEs) provide web-based expert consultation, with documentation stored in a medical consultation database (MCD). MCD analysis can reveal inquiry trends among panel physicians worldwide. METHODS: TB-related queries in the COE MCD from January 1, 2018, to December 31, 2022, were analyzed using a descriptive coding scheme developed through inductive analysis, allowing multiple themes per entry. RESULTS: A total of 215 queries from 126 patients in 28 countries were analyzed. Major themes included evaluating diagnostic criteria, tailoring treatment, and managing comorbidities or adverse reactions. Diagnostic questions (n = 104, 48.4%) included mycobacterial culture, smear, and radiology interpretation. Treatment tailoring inquiries involved optimizing the initial regimen (n = 89, 41.4%) or modifying existing regimens (n = 26, 12.1%). Additionally, 50 consultations (23.2%) mentioned comorbidities, while 47 (21.9%) described adverse reactions. CONCLUSION: The MCD analysis identified topics where TB expertise was provided in overseas medical evaluation. These topics highlight opportunities for targeted panel physician education to improve the health of individual applicants and advance U.S. TB elimination efforts. |
| format | Article |
| id | doaj-art-047bf1666923444485cc77f3d2fdcf66 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-047bf1666923444485cc77f3d2fdcf662025-01-23T13:39:03ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-11-0111149049410.5588/ijtldopen.24.00563Analysis of panel physician inquiries to U.S. TB Centers of Excellence, 2018–2022E. Leithead IV0S. Subramanian1K. Pimenta2N.D. Goswami3A. Patrawalla4A. Lardizabal5C. Haley6L. Chen7L. Armitige8B. Seaworth9B. Sylvester10R. Bhavaraju11Rutgers New Jersey Medical School, Newark, NJ, USA;Rutgers New Jersey Medical School, Newark, NJ, USA;School of Public Health, University of Memphis, Memphis, TN, USA;Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA;Rutgers Global Tuberculosis Institute, Newark, NJ, USA;Rutgers Global Tuberculosis Institute, Newark, NJ, USA;Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA;UCSF Curry International Tuberculosis Center, San Francisco, CA, USA;Heartland National TB Center, San Antonio, TX, USA;Heartland National TB Center, San Antonio, TX, USA;Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.Rutgers New Jersey Medical School, Newark, NJ, USA;BACKGROUND: Applicants seeking entry into the United States are examined overseas for TB by panel physicians and international immigration clinicians guided by Centers for Disease Control and Prevention (CDC) TB Technical Instructions. To support this effort, CDC-funded TB Centers of Excellence (COEs) provide web-based expert consultation, with documentation stored in a medical consultation database (MCD). MCD analysis can reveal inquiry trends among panel physicians worldwide. METHODS: TB-related queries in the COE MCD from January 1, 2018, to December 31, 2022, were analyzed using a descriptive coding scheme developed through inductive analysis, allowing multiple themes per entry. RESULTS: A total of 215 queries from 126 patients in 28 countries were analyzed. Major themes included evaluating diagnostic criteria, tailoring treatment, and managing comorbidities or adverse reactions. Diagnostic questions (n = 104, 48.4%) included mycobacterial culture, smear, and radiology interpretation. Treatment tailoring inquiries involved optimizing the initial regimen (n = 89, 41.4%) or modifying existing regimens (n = 26, 12.1%). Additionally, 50 consultations (23.2%) mentioned comorbidities, while 47 (21.9%) described adverse reactions. CONCLUSION: The MCD analysis identified topics where TB expertise was provided in overseas medical evaluation. These topics highlight opportunities for targeted panel physician education to improve the health of individual applicants and advance U.S. TB elimination efforts.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000011/art00003tuberculosismedical consultationguidanceimmigrationpanel physician |
| spellingShingle | E. Leithead IV S. Subramanian K. Pimenta N.D. Goswami A. Patrawalla A. Lardizabal C. Haley L. Chen L. Armitige B. Seaworth B. Sylvester R. Bhavaraju Analysis of panel physician inquiries to U.S. TB Centers of Excellence, 2018–2022 IJTLD Open tuberculosis medical consultation guidance immigration panel physician |
| title | Analysis of panel physician inquiries to U.S. TB Centers of Excellence, 2018–2022 |
| title_full | Analysis of panel physician inquiries to U.S. TB Centers of Excellence, 2018–2022 |
| title_fullStr | Analysis of panel physician inquiries to U.S. TB Centers of Excellence, 2018–2022 |
| title_full_unstemmed | Analysis of panel physician inquiries to U.S. TB Centers of Excellence, 2018–2022 |
| title_short | Analysis of panel physician inquiries to U.S. TB Centers of Excellence, 2018–2022 |
| title_sort | analysis of panel physician inquiries to u s tb centers of excellence 2018 2022 |
| topic | tuberculosis medical consultation guidance immigration panel physician |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000011/art00003 |
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