Evidence-based diagnosis in primary care : a practical by Andrew Polmear

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By Andrew Polmear

This booklet has been ready by way of execs operating within the united kingdom and units out the foundations and perform of EBM in basic care prognosis. Giving tips on over a hundred indicators and problems, the publication illustrates the elemental concerns: that the price of a heritage, exam and research is determined by the patient's earlier likelihood of affliction and at the atmosphere and services of the physician. Many chapters function 'red flags' - parts of the background or exam that are meant to alert us to the potential for severe disorder, that are very important for normal perform

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14. Buckley R, King K, Disney J, et al. History and physical examination to estimate the risk of ectopic pregnancy: validation of a clinical prediction model. Ann Emerg Med 1999;34:589–594. 15. Della-Giustina D, Denny M. Ectopic pregnancy. Emerg Med Clin North Am 2003;21:565–584. 16. Mol B, Hajenius P, Engelsbel S, et al. Should patients who are suspected of having an ectopic pregnancy undergo physical examination? Fertil Steril 1999;71:155–157. 17. Dart R, Kaplan B, Varaklis K. Predictive value of history and physical examination in patients with suspected ectopic pregnancy.

REFERENCES 1. The BRIDGE Study Group. The presentation and management of breast symptoms in general practice in South Wales. Br J Gen Pract 1999;49: 811–812. 2. Barton M, Elmore J, Fletcher S. Breast symptoms among women enrolled in a Health Maintenance Organization: frequency, evaluation and outcome. Ann Intern Med 1999;130: 651–657. 3. Dixon J, Mansel R. ABC of breast diseases: congenital problems and aberrations of normal breast development and involution. BMJ 1994; 309:797–800. 4. Barton M, Harris R, Fletcher S.

Other manoeuvres are described2,13 but are rarely performed in general practice. How reliable is the examination in the diagnosis of a cardiac murmur? Two systematic reviews found that cardiologists were good at deciding, on the basis of the clinical examination, whether systolic4 and diastolic14 murmurs were innocent, doubtful or an indication of cardiac disorder, although the evidence from some settings was less impressive than from others. 2 However, auscultation of the heart is a skill in which the performance of nonspecialists is very different.

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