Diagnostic uncertainty in general practice

Diagnostic uncertainty: dichotomies are not the answer

“…6 The explicit identification of this subgroup would facilitate a focused stream of diagnostic and prognostic research into the efficacy of different strategies used to manage these patients.…”

“…5 Research designed around the explicit identification of patients with 'undifferentiated presentations' would facilitate the evaluation of different strategies to handle this subgroup in clinical practice. 6 This would impact significantly on general practice, providing GPs with a set of validated tools to confidently handle diagnostic uncertainty.…”

Investigation of diseases that cause diagnostic difficulty for Japanese general physicians

“…But recently, Japan has faced the problems of a rapidly aging population, financial constraints, and both a shortage and unbalanced distribution of doctors, with the need to improve the primary care system and delivery of general medicine being pointed out [2]. Primary care physicians are expected to perform a wide range of roles, such as management and prevention of common diseases, and one of their vital tasks is to detect patients with serious diseases among the many patients they encounter in daily practice [3,4]. Patients who present to general practitioners are often at an early stage in the natural history of their disease and have vague, atypical or confusing symptoms, resulting in a wide range of diagnostic possibilities [5].…”

Diagnostic evaluation of smear negative tuberculosis in a resource poor setting

“…It has also been shown that RNS are actively produced in human TB, although their relative importance is controversial [65][66][67][68][69][70]. Thus, uncertainties exist for the use of NO to diagnose TB prior to initiation of therapy, the most important being the degree to which this biomarker can differentiate recent or progressive from latent infection [71].…”

“…For example, safety-netting has been proposed as a method of reducing the risk of missing serious disease in patients with an 'uncertain' diagnostic outcome [68]. Research designed around the explicit identification of patients with 'undifferentiated presentations' would facilitate the evaluation of different strategies for programme managers to policy-makers and from medical personnel to handle this subgroup in clinical practice [69]. This would impact significantly on general practice, providing clinicians with a set of validated tools to confidently handle uncertain diagnostic outcome.…”