The Primary Care Differential Diagnosis of Inhalational Anthrax
By Jonathan L. Temte, M.D., Ph.D., et al
When asked to assign nonanthrax diagnoses to inhalational anthrax case vignettes, family physicians' diagnoses were grouped into 35 categories, with pneumonia (42 percent), influenza (10 percent), viral syndrome (9 percent), septicemia (8 percent), bronchitis (7 percent), central nervous system infection (6 percent), and gastroenteritis (4 percent) accounting for 86 percent of all diagnoses. The authors point out that many of these disorders are relatively common in primary care practices. Consequently, surveillance systems for early detection of bioterrorism events that scan electronic medical data for these diagnoses or clusters of diagnoses are likely to produce high levels of false-positive signals.

The Spirituality Index of Well-Being: A New Instrument for Health-Related Quality-of-Life Research
By Timothy P. Daaleman, D.O., et al
Researchers determined that the Spirituality Index of Well Being, an instrument used to measure the effect of spirituality on well-being, is a valid and reliable measure of well-being in primary care outpatients. They suggest the instrument may be useful in studies that investigate health-related quality-of-life and chronic illness, aging and end-of-life care.

Adapting Psychosocial Intervention Research to Urban Primary Care Environments: A Case Example
By Luis H. Zayas, Ph.D., et al
Although practice-based research may have greater relevance and applicability to primary care patients than laboratory studies, it does have its challenges. The authors use a case study to discuss several challenges associated with psychosocial intervention research in community-based primary care. The authors posit several criter
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Contact: Angela Lower
alower@aafp.org
913-906-6253
American Academy of Family Physicians
5-Oct-2004