UTILIZATION OF TESTS FOR LYME-DISEASE ANTIBODY AT A UNIVERSITY HOSPITAL

We performed a retrospective study on patients who had a positive scre ening antibody test result for antibody to Borrelia burgdorferi to det ermine the clinical indicators used by physicians to order this test. Eighty-two evaluable patients who were screen positive (indirect enzym e-linked immunosorbent assay) between August 1991 and March 1993 were included. Additional tests, isotype-specific capture immunoglobulin en zyme immunoassay and Western blot (immunoblot) analysis (immunoglobuli n G), were performed on positive samples. Of 82 patients with a positi ve screening test result, 54 (66%) had no serologic evidence of Lyme d isease on the basis of additional testing (positive predictive value, 34%). Only 28 of 82 patients (34%) had clinical indicators suggestive of Lyme disease. Antibody screening tests may provide misleading infor mation if they are not accompanied by more specific assays. Inappropri ate testing of patients without indications of Lyme disease is frequen tly performed, and the ordering practices of physicians should be reas sessed.