scholarly journals The added value of radiographs in diagnosing knee osteoarthritis is similar for general practitioner and secondary care physician

2020 ◽  
Vol 28 ◽  
pp. S40
Author(s):  
Q. Wang ◽  
J. Runhaar ◽  
M. Kloppenburg ◽  
J. Bijlsma ◽  
S. Bierma-Zeinstra
Keyword(s):  
General Practitioner ◽  
Knee Osteoarthritis ◽  
Secondary Care ◽  
Care Physician ◽  
Added Value

scholarly journals The Added Value of Radiographs in Diagnosing Knee Osteoarthritis Is Similar for General Practitioners and Secondary Care Physicians; Data from the CHECK Early Osteoarthritis Cohort

2020 ◽  
Vol 9 (10) ◽  
pp. 3374
Author(s):  
Qiuke Wang ◽  
Jos Runhaar ◽  
Margreet Kloppenburg ◽  
Maarten Boers ◽  
Johannes Bijlsma ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
General Practitioners ◽  
Secondary Care ◽  
Negative Likelihood Ratio ◽  
Final Diagnosis ◽  
Added Value ◽  
Early Osteoarthritis ◽  
Sensitivity Specificity ◽  
Radiographic Data

Objective: The purpose of this study was to evaluate the added value of radiographs for diagnosing knee osteoarthritis (KOA) by general practitioners (GPs) and secondary care physicians (SPs). Methods: Seventeen GPs and nineteen SPs were recruited to evaluate 1185 knees from the CHECK cohort (presenters with knee pain in primary care) for the presence of clinically relevant osteoarthritis (OA) during follow-up. Experts were required to make diagnoses independently, first based on clinical data only and then on clinical plus radiographic data, and to provide certainty scores (ranging from 1 to 100, where 1 was “certainly no OA” and 100 was “certainly OA”). Next, experts held consensus meetings to agree on the final diagnosis. With the final diagnosis as gold standard, diagnostic indicators were calculated (sensitivity, specificity, positive/negative predictive value, accuracy and positive/negative likelihood ratio) for all knees, as well as for clinically “certain” and “uncertain” knees, respectively. Student paired t-tests compared certainty scores. Results: Most diagnoses of GPs (86%) and SPs (82%) were “consistent” after assessment of radiographic data. Diagnostic indicators improved similarly for GPs and SPs after evaluating the radiographic data, but only improved relevantly in clinically “uncertain” knees. Radiographs added some certainty to “consistent” OA knees (GP 69 vs. 72, p < 0.001; SP 70 vs. 77, p < 0.001), but not to the consistent no OA knees (GP 21 vs. 22, p = 0.16; SP 20 vs. 21, p = 0.04). Conclusions: The added value of radiographs is similar for GP and SP, in terms of diagnostic accuracy and certainty. Radiographs appear to be redundant when clinicians are certain of their clinical diagnosis.

Indications for paediatric tonsillectomy GP versus Consultant perspective

1994 ◽  
Vol 108 (2) ◽  
pp. 131-134 ◽  
Author(s):  
M. J. Donnelly ◽  
M. S. Quraishi ◽  
D. P. McShane
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Primary Care Physician ◽  
General Practitioners ◽  
Questionnaire Survey ◽  
Care Physician ◽  
The Past ◽  
Ear Infections ◽  
Glue Ear

AbstractTonsillectomy is a commonly performed operation in children. Although the justification for this procedure has been debatable in the past, more rigorous criteria in defining the need for tonsillectomies are becoming established. The role of the primary care physician in the management of tonsillar disease in children is important as the decision to refer a child for tonsillectomy is made by the general practitioner. A questionnaire survey of 400 general practitioners (GPs) and 31 consultant ENT surgeons was carried out to establish the important criteria used in deciding the need for paediatric tonsillectomy. We found that in general there was a good correlation between GP and Consultant indications for tonsillectomy. However there were two important areas of difference, while most of the GPs felt that recurrent ear infections and ‘glue ear’ were important indications for tonsillectomy, Consultants did not. Therefore we must be aware of the current recommendations for tonsillectomy and inform present and future GPs.

scholarly journals Pharmaceuticals in treatment of oral mucosal manifestations of manifestations of various diseases on the oral mucosa

2021 ◽  
Vol 2 (7) ◽  
pp. 56-62
Author(s):  
Irina Lutskaya ◽  
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Primary Care Physician ◽  
Oral Mucosa ◽  
Functional State ◽  
Dental Care ◽  
Treatment Efficacy ◽  
Clinical Manifestations ◽  
Care Physician ◽  
Symptomatic Therapy

The paper reports principles for etiotropic and symptomatic therapy of oral mucosal diseases. The options for dental care tactics selection by the general practitioner, the primary care physician, based on the clinical manifestations are discussed using certain nosological entities as examples. It has been shown that general functional state of the organism plays a vital part in achieving treatment efficacy.

Primary care presentation

2013 ◽  
Author(s):  
Elspeth Wise
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Secondary Care ◽  
Care Setting ◽  
School Curriculum ◽  
Management Plan ◽  
Medical Professional ◽  
Care Physician ◽  
Musculoskeletal Problem ◽  
Primary Care Patients

For many patients their first presentation to a medical professional with a musculoskeletal complaint is in a primary care setting. They may have as little as 10 minutes to explain their problem, be examined, and have a management plan determined. Quite commonly the musculoskeletal problem may present as an aside—by the way doctor, while I'm here'. All of this presents a challenge to the assessing primary care physician, who may have had little specific training for what makes up a large part of their workload. What training they have had may be inappropriate for their day-to-day job, as it is often secondary care led. The conditions that are classically seen in a secondary care setting and that are emphasized in the medical school curriculum are rarely seen in primary care. Patients also may not necessarily present with the classical symptoms described in textbooks; often it is over time, and with repeated contact, that the diagnosis may become more obvious. This chapter looks at the prevalence data for primary care and discusses the routine workload of a primary care physician.

Urology general practitioner advice and guidance: A service evaluation of its effectiveness

2019 ◽  
Vol 12 (6) ◽  
pp. 455-461
Author(s):  
Brendan Berry ◽  
Nikesh Thiruchelvam
Keyword(s):  
General Practitioner ◽  
National Health Service ◽  
Secondary Care ◽  
Service Evaluation ◽  
University Hospitals ◽  
Level Of Evidence ◽  
Cambridge University ◽  
Care Services ◽  
Clinical Benefits ◽  
Data Points

Objective: This study aims to assess the effectiveness of the Urology Advice and Guidance (A&G) referral pathway within the National Health Service (NHS). It seeks to identify whether the A&G system helps to prevent unnecessary referrals to secondary care services and endeavours to see whether there is any variability in consultant responses to A&G queries, and whether this affects how patients are subsequently managed. Patients and methods: This study uses patient data collected by Cambridge University Hospitals NHS Foundation Trust over a six-month period between 2016 and 2017. The correspondence from 192 A&G referrals was analysed to extract 11 data points from each referral to help analyse the aims of the study. Results: The results showed that almost half of all A&G referrals could be avoided if general practitioners made better use of the urology guidelines made available to them. The results also demonstrated that A&G referrals were more appropriately managed when guidance was given by a consultant with subspecialty interests in line with the referral. Conclusion: The aims of this study were appropriately met, and the study outlines how improvements in the A&G service could offer both financial and clinical benefits to primary and secondary care services alike. Level of evidence: 3b

Oncological alertness in patients at outpatient therapeutic stage

2021 ◽  
pp. 41-45
Author(s):  
A. S. Sycheva ◽  
A. L. Vertkin ◽  
A. L. Kebina
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Primary Care Physicians ◽  
Detection Rate ◽  
Care Physician ◽  
Malignant Neoplasms ◽  
Main Task ◽  
Oncological Diseases ◽  
Advanced Stages ◽  
Specialized Institution

Objective. Increasing the detection rate of oncological diseases in the early stages using questionnaires.Materials and methods. The study involved 25,467 patients who came to an appointment with a general practitioner / general practitioner for any request. During the study, primary care physicians, regardless of the purpose of the visit, purposefully asked questions regarding the risks of malignant neoplasms.Results. The detection rate of oncological diseases was 60.4% in the first half of 2018 against 56.3% in the same period of 2017. In accordance with specific localizations, the following results were obtained: detection of stomach cancer increased by 3%, colon cancer by 2%, malignant neoplasms of the trachea, bronchi and lungs increased by 6%, and the mammary gland, cervix and prostate increased by 1%, 8%, and 2%, respectively.Conclusions. The presence of a clear stereotype of oncological alertness in the primary care physician may contribute to a decrease in the number of advanced stages of tumors due to the initiation of specialized treatment at earlier stages. In such a situation, the main task of the therapist and general practitioner is to identify suspicious symptoms of malignant neoplasms using an algorithmized approach and refer the patient to a specialized institution.

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