As the incidence of tuberculosis (TB) in Canada declines, so too does the experience of physicians with this disease. What impact will this have on patient survival?
Khan and colleagues looked at cases of active (showing clinical signs) TB reported in Toronto over 3 years. They found that 2 modifiable factors positively influenced survival: use of directly observed therapy (in this study, patients were given their medication during home visits by public health staff) and physician experience with TB.
In a related commentary, Long points out the many challenges that TB treatment presents and calls on public health departments to define the roles and responsibilities of physicians, regions, clinics and provinces with respect to the prevention and management of patients with active TB.
p. 749 The impact of physician training and experience on the survival of patients with active tuberculosis
-- K. Khan et al
http://www.cmaj.ca/pressrelease/pg749.pdf
p. 759 Physician experience, public health and the management of tuberculosis
-- R. Long
http://www.cmaj.ca/pressrelease/pg759.pdf
Canadian Medical Association Journal