Evidence based information on diagnostic tests will help

How many general practitioners will read this week's paper by Arroll et al on diagnosing depression (p 1144)1 and sigh, “Another thing we have to do”? On the face of it we have a simple and accurate “test” for depression that is effective. Does this then 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 we can simplify our clinical work?

Making diagnoses has often been taught as a long and complicated process. “First take a thorough history” is the unhelpful advice from textbooks. What does that mean? Ask what is often a muddle of questions, and listen to a lot of information. Then pursue some lines of inquiry …