Version 1
: Received: 24 May 2022 / Approved: 25 May 2022 / Online: 25 May 2022 (10:15:19 CEST)
Version 2
: Received: 26 May 2022 / Approved: 27 May 2022 / Online: 27 May 2022 (08:48:07 CEST)
Version 3
: Received: 30 May 2022 / Approved: 31 May 2022 / Online: 31 May 2022 (09:14:56 CEST)
How to cite:
Romain, L.; Verger, P.; Peretti-Watel, P.; Eldin, C. When the Patient Is Making the (Wrong?) Diagnosis: A Biographical Approach to Patients Consulting for Presumed Lyme Disease. Preprints2022, 2022050350. https://doi.org/10.20944/preprints202205.0350.v3.
Romain, L.; Verger, P.; Peretti-Watel, P.; Eldin, C. When the Patient Is Making the (Wrong?) Diagnosis: A Biographical Approach to Patients Consulting for Presumed Lyme Disease. Preprints 2022, 2022050350. https://doi.org/10.20944/preprints202205.0350.v3.
Cite as:
Romain, L.; Verger, P.; Peretti-Watel, P.; Eldin, C. When the Patient Is Making the (Wrong?) Diagnosis: A Biographical Approach to Patients Consulting for Presumed Lyme Disease. Preprints2022, 2022050350. https://doi.org/10.20944/preprints202205.0350.v3.
Romain, L.; Verger, P.; Peretti-Watel, P.; Eldin, C. When the Patient Is Making the (Wrong?) Diagnosis: A Biographical Approach to Patients Consulting for Presumed Lyme Disease. Preprints 2022, 2022050350. https://doi.org/10.20944/preprints202205.0350.v3.
Abstract
Background: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10-20% of patients, with a significant number remaining in a diagnostic dead-end. Objectives: To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. Methods: In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semi-structured interviews. The inclusion criteria were : suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients’ medical trajectories were collected using a biographical approach. Results: The diagnosis of Lyme disease was primarily triggered by identification with personal testimonies found on the internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. Conclusion: GPs should first systematically explore patients’ etiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.
Keywords
lyme disease; clinical decision-making; medical history taking; physician-patient relation; primary health care; qualitative research
Subject
MEDICINE & PHARMACOLOGY, General Medical Research
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Commenter: Romain Lutaud
Commenter's Conflict of Interests: Author