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Editorial |
Evidence-based diagnosis in general practice: needs both robust evidence and sophisticated electronic health record systems
Division of Health and Social Care Research, Kings College London, 7th Floor, Capital House, 42 Weston Street, London SE1 3QD, UK
Correspondence to Brendan Delaney, Division of Health and Social Care Research, Kings College London, 7th Floor, Capital House, 42 Weston Street, London SE1 3QD, UK; E-mail: brendan.delaney@kcl.ac.uk
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General practice is the point of first contact with the health care system in many countries whether or not general practitioners have a ‘gatekeeper’ role. It is characterized by early disease (and consequently, non-specific and atypical presentations), a wide range of potential diagnoses, co-morbid illness (associated with an increase in chronic conditions treated in primary care) and low prevalence of serious morbidity. These characteristics underline the diagnostic difficulties and conflicting demands that GPs face. Often as gatekeepers of the health care system, GPs are under pressure to reduce ‘unnecessary’ investigations and referrals. At the same time, they are required to detect serious conditions early on—but are not always successful. Missed malignancies and myocardial infarctions account
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