Misuse of Laboratory Tests and Diagnostic Procedures

Griner, Paul F.; Glaser, Robert

doi:10.1056/nejm198211183072109

Cited by 119 publications

(27 citation statements)

References 13 publications

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“…Excessive test ordering is often an indication that the diagnostician has not effectively refined his/her differential diagnoses in the history and physical examination and is relying on the investigations to diagnose the problem (Griner and Glaser, 1982). Does a raised awareness of cost in Year Four, however, have a significant effect on the number and appropriateness of tests ordered by students, now or in later practice?…”

Section: Cost Awareness An Advantagementioning

confidence: 99%

Evaluation of a Diagnostic Reasoning Program (DxR): Exploring Student Perceptions and Addressing Faculty Concerns

Bryce

King

Graebner

et al. 1998

JIME

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Abstract:Clinical reasoning is essentially a problem-solving process, in which medical students must learn to gather and interpret data, generate hypotheses and make decisions. To develop skills in problem-solving it is argued that students need more tools, rather than more answers (Masys, 1989). DxR is a computerised case series, in which students use 'doctor tools' to investigate a patient problem. This report describes a pilot evaluation of DxR in fourth year medicine at the University of Sydney. It addresses faculty concerns regarding the program, explores student perceptions, and looks at the capacity of the program to stimulate and support the development of clinical reasoning skills. It finally discusses possibilities for using DxR to support learning inmedicine.

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Section: Cost Awareness An Advantagementioning

confidence: 99%

Evaluation of a Diagnostic Reasoning Program (DxR): Exploring Student Perceptions and Addressing Faculty Concerns

Bryce

King

Graebner

et al. 1998

JIME

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“…Howevcr, the contribution of repeated, routine laboratory examinations to the actual treatment of the illness is usually of limited value ( I , 2 ) . Prognostic classification based on clinical findings may be equally efficient in distinguishing patients a t risk of serious morbidity from those who are likely to d o well (3). Furthermore, most patients suffering from meningitis worldwide live in circuinstances where modern facilities are virtually non-existent.…”

mentioning

confidence: 99%

Clinical criteria for estimating recovery from childhood bacterial meningitis

Anttila

1994

Acta Paediatrica

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A comparison study was conducted between 105 children (aged 3 months to 15 years) who had recovered from bacterial meningitis uneventfully and 29 children who had suffered from subsequent neurological complications or sequelae. The objective was to find a potential correlation between easily measurable clinical variables and the risk of developing neurological complications. Sixteen clinical signs and measurements routinely registered in patients with bacterial meningitis were recorded daily during the first 14 days of hospitalization. Differences found between the two groups were mean morning temperature, presence of neck rigidity and willingness to leave the supine position. The results indicate that if a child recovering from bacterial meningitis continues to be feverish, has neck rigidity, or is reluctant to leave the supine position over seven days, she/he runs a special risk of developing neurological complications or sequelae, which should be actively sought for using all available measures.

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“…Test ordering accounts for substantial health care costs and is frequently excessive (1). A variety of interventions have been used to reduce test ordering, including administrative procedures, feedback to physicians, education regarding appropriateness, and financial incentives (reviewed in reference 2).…”

Section: Concise Communicationmentioning

confidence: 99%