[IMPROVEDX] [IMPROVEDX] IOM report is released - Diagnosis in actual practice

Mark H Ebell ebell at UGA.EDU
Wed Oct 14 03:31:21 UTC 2015


I have done or am in the process of doing/being reviewed systematic reviews on the following topics:

H&P to diagnosis influenza
Clinical rules to diagnose influenza
H&P to diagnose sinusitis
Lab and imaging to diagnose sinusitis
Tamiflu for influenza
Clinical diagnosis of sore throat
Clinical diagnosis of infectious mononucleosis

Others have done excellent reviews of acute bronchitis, etc. Trust me, the evidence base is, in a word, crap.

We need a dedicated institute that supports research in the primary care setting. PCORI has been a huge disappointment – the usual recipients, the usual topics, not primary care focused, diagnosis almost entirely excluded. AHRQ is a good source, but is not focused on primary care, and is not well funded. I just returned from the GP Research on Infection Network meeting in Ireland, and am incredibly jealous of the support my colleagues in Europe get from their governments. Governments that actually seem to care about primary care research.

Best,

Mark

From: robert bell
Date: Tuesday, October 13, 2015 at 11:25 PM
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>", Mark Ebell
Subject: Re: [IMPROVEDX] [IMPROVEDX] [IMPROVEDX] IOM report is released - Diagnosis in actual practice

That would be something well worth exploring.

There may be a lot of studies around the world once one started looking.

Rob Bell, MD
On Oct 13, 2015, at 6:58 PM, Mark H Ebell <ebell at UGA.EDU<mailto:ebell at UGA.EDU>> wrote:

And of course, the most common things (acute bronchitis, common cold, sore throat, dyspepsia, dizziness, headache) are almost unstudied in the primary care setting. We need a dedicated institute of primary care led by family physicians and general internists.

Mark

From: robert bell
Reply-To: Society to Improve Diagnosis in Medicine, robert bell
Date: Tuesday, October 13, 2015 at 7:01 PM
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>"
Subject: Re: [IMPROVEDX] [IMPROVEDX] [IMPROVEDX] IOM report is released - Diagnosis in actual practice

Interesting Art,

The commonest diagnoses lead the the commonest diagnostic errors.

Could that be the confounding presentations that we see over time - and for which we arenot well trained?

Rob


On Oct 13, 2015, at 11:23 AM, Jason Maude <Jason.Maude at ISABELHEALTHCARE.COM<mailto:Jason.Maude at ISABELHEALTHCARE.COM>> wrote:

In our specialty we scratch our heads when so many skin cancers are missed by PCP’s, or scabies, or herpetic infections etc.  These are all common diagnoses.  Mathematically, variants of common (or at least diagnoses that we all know) are the mass of the diagnostic error iceberg.


Robert M. Bell, M.D., Ph.C.
P.O. Box 3668
West Sedona, AZ  86340-3668
USA
Tel: Fax: 928 203-4517




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Robert M. Bell, M.D., Ph.C.
P.O. Box 3668
West Sedona, AZ  86340-3668
USA
Tel: Fax: 928 203-4517




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