Analysis of Temporal Artery Biopsy by Provider Across a Large Multi-State Health Care Network.

Abstract

Temporal artery biopsy (TAB) is the standard test for diagnosing giant cell arteritis. Our objective was to determine which specialists perform TABs and if there is variation across the United States. We performed a cross-sectional analysis in a multi-state health care system, evaluating differences between observed counts of surgical specialty by region, positive diagnoses by region, and positive diagnoses by specialty. Temporal arterial biopsy was performed on 3825 patients with the proportion of specialties performing TAB differing between regions. Temporal artery biopsy was performed by a significantly higher percentage of general surgeons in the Midwest (53.6%) and less vascular surgeons in the West (30.4%). The percentage of positive diagnoses was higher for vascular surgeons (32.7%). We concluded that TAB is performed by physicians of many specialties with the specialty performing most of these procedures varying by region. There is also a difference in the rate of positive diagnoses that varies with surgical specialty.