Evaluation of educational interventions for three lesser-known illnesses.

Background: Lesser known illnesses (LKI) such as hemochromatosis, celiac disease, and Lyme disease are likely to be under-diagnosed due to the often varied and sometimes vague symptoms and lack of familiarity with testing. Insufficient testing and diagnoses of these LKI could result in poor outcomes for patients and unnecessary costs.

Objectives: The objective of this research was to evaluate the effectiveness of educational campaigns designed to inform physicians about the symptoms of LKIs and the basis to test patients for the diseases.

Methods: A multi-level educational intervention was designed and conducted. The prevalence rate of testing, diagnosis, and the ratio of diagnoses to testing (D/T ratio) for hemochromatosis, celiac disease, and Lyme disease were determined for pre-intervention, intervention, and post-intervention time periods. Using the prevalence rates, ANOVA regression analysis was used to estimate the effect of the educational intervention on clients in Medicare Professional System, Medicare Institutional System, and Christiana Care outpatient data.

Results: The educational intervention appeared effective at increasing the rate of testing, diagnosis, and the ratio of diagnoses to tests, within the Medicare Institutional System. Generally low rates of the LKI were observed, with large monthly volatility in testing and diagnosis rates.

Conclusion: The low yields of diagnosis, represented by small D/T ratios, indicate that considerable financial resources have been employed for testing without increased detection of cases above those that would have otherwise been identified.