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Medical Practice

Further Observations on Diagnosis and Management of General Practice Respiratory Illness using Simulated Patient Consultations

Br Med J 1974; 2 doi: (Published 08 June 1974) Cite this as: Br Med J 1974;2:540
  1. J. G. R. Howie


    Twenty general practitioners co-operated in a study of the decision-making process in general practice respiratory illness. Ten simulated standard-patient consultations were used, each being included twice, once to make a decision on diagnosis and once to make a decision on management.

    Comparison of simulated behaviour with previous studies of observed and self-recorded behaviour showed encouraging agreement. Examination of 200 pairs of management and treatment decisions showed that fewer pieces of information were required for a management than a diagnostic decision on 111 occasions; in 43 pairs the quantity required was the same for each decision. The exact information required to make a decision on diagnosis was included in the information required to decide management on only 30 (15%) of the 200 possible occasions.

    When disagreement was found over management of a simulated case a decision to prescribe an antibiotic required less information than a decision not to prescribe an antibiotic.