Abstract WP407: Physician Knowledge Regarding Transcranial Doppler Screening Recommendations Among Children with Sickle Cell Disease

Abstract

Background: Transcranial Doppler (TCD) screening for stroke prevention among children with sickle cell disease (SCD) is recommended by the National Heart, Lung and Blood Institute (NHLBI); however, screening rates remain low. Little is known about provider knowledge of TCD recommendations. We explored knowledge of current TCD recommendations for children with SCD among pediatric hematologists and neurologists across the US, as well as pediatric primary care physicians (PCPs) of children with SCD in Michigan. Methods: Pediatric hematologists and neurologists (n=250 each) were sampled from the American Medical Association Masterfile, a listing of all US physicians. PCPs were pediatricians/family physicians treating children with SCD in Michigan identified through Medicaid claims 2008-2012 (n=206). A mailed survey was administered May 2012 with a 6 week follow-up to non-respondents. The survey included 6 questions regarding knowledge of TCD recommendations based on age and SC subtypes, as well as actions to take based on TCD results. The proportion of correct responses was classified based on NHLBI guidelines and compared across specialty using Fisher’s exact tests. Results: Among 638 deliverable surveys, 244 (38%) were returned (83 neurologists, 89 hematologists, 72 PCPs) and 103 indicated the respondent currently treats children with SCD and believes children with SCD should receive TCD screening. Among these respondents, 76% recommend TCD screening and 24% of the knowledge questions were answered correctly (Table 1). Differences in proportion correct overall and for specific questions were noted across specialty, with hematologists having the highest proportion correct. Conclusions: Although the majority of physicians recommend TCD screening, knowledge of specific TCD recommendations is low. Opportunities to improve knowledge of TCD recommendations span each physician specialty sampled, but are especially evident among PCPs and neurologists.