How many conditions can a GP screen for?

doi:10.1136/bmj.327.7424.1117

BMJ 2003;327:1117 (15 November), doi:10.1136/bmj.327.7424.1117

Editorial

How many conditions can a GP screen for?

Evidence based information on diagnostic tests will help

The first 150 words of the full text of this article appear below.

How many general practitioners will read this week's paper byArroll et al on diagnosing depression (p 1144)¹ and sigh, "Anotherthing we have to do"? On the face of it we have a simple andaccurate "test" for depression that is effective. Does thisthen impose a burden on the backs of general practitioners,another duty that will attract censure if not done properly?We think not. Rather, we ask what can be dropped, and how wecan simplify our clinical work?

Making diagnoses has often been taught as a long and complicatedprocess. "First take a thorough history" is the unhelpful advicefrom textbooks. What does that mean? Ask what is often a muddleof questions, and listen to a lot of information. Then pursuesome lines of inquiry and not others. Finally synthesise thisto come up with a list of possibilities (the differential diagnoses).

. . . [Full text of this article]

Chris Del Mar, professor of general practice

Centre for General Practice, University of Queensland, Brisbane, QLD 4006, Australia (c.delmar@cgp.uq.edu.au)

Paul Glasziou, director

University of Oxford, Department of Primary Health Care, Institute of Health Sciences, Oxford OX3 7LF

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