Analysis of questions asked by family doctors regarding patient care
BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7206.358 (Published 07 August 1999) Cite this as: BMJ 1999;319:358Data supplement
Table w2 Taxonomy of topics
Identification No
Category
No of questions (% of total of 1101)
General
Specific
1.1
Adult medicine
General internal medicine
24 (2.2)
1.2
Adult medicine
Adult infectious disease
89 (8.1)
1.3
Adult medicine
Adult oncology
4 (0.4)
1.4
Adult medicine
Adult endocrinology
31 (2.8)
1.5
Adult medicine
Adult allergy and immunology
1 (0.1)
1.6
Adult medicine
Adult rheumatology
11 (1.0)
1.7
Adult medicine
Adult haematology
13 (1.2)
1.8
Adult medicine
Adult psychiatry
45 (4.1)
1.9
Adult medicine
Adult neurology
41 (3.7)
1.10
Adult medicine
Adult cardiovascular disease
70 (6.4)
1.11
Adult medicine
Adult respiratory disease
22 (2.0)
1.12
Adult medicine
Adult gastroenterology
36 (3.3)
1.13
Adult medicine
Adult nephrology
23 (2.1)
1.14
Adult medicine
Occupational medicine
3 (0.3)
1.15
Adult medicine
Physical medicine and rehabilitation
1 (0.1)
1.16
Adult medicine
Geriatrics
3 (0.3)
1.17
Adult medicine
Alternative medicine
1 (0.1)
2.1
Pediatrics
General pediatrics
11 (1.0)
2.2
Pediatrics
Pediatric infectious disease
45 (4.1)
2.3
Pediatrics
Pediatric oncology
0
2.4
Pediatrics
Pediatric endocrinology
1 (0.1)
2.5
Pediatrics
Pediatric allergy and immunology
0
2.6
Pediatrics
Pediatric rheumatology
0
2.7
Pediatrics
Pediatric haematology
2 (0.2)
2.8
Pediatrics
Child psychiatry
5 (0.5)
2.9
Pediatrics
Pediatric neurology
2 (0.2)
2.10
Pediatrics
Pediatric cardiovascular disease
4 (0.4)
2.11
Pediatrics
Pediatric respiratory disease
1 (0.1)
2.12
Pediatrics
Pediatric gastroenterology
4 (0.4)
2.13
Pediatrics
Pediatric nephrology
1 (0.1)
2.14
Pediatrics
Genetics
2 (0.2)
2.15
Pediatrics
Neonatology
6 (0.5)
2.16
Pediatrics
Adolescent medicine
0
3.1
Surgery
General surgery
15 (1.4)
3.2
Surgery
Orthopaedics
67 (6.1)
3.3
Surgery
Otolaryngology
38 (3.5)
3.4
Surgery
Ophthalmology
8 (0.7)
3.5
Surgery
Neurosurgery
1 (0.1)
3.6
Surgery
Urology
31 (2.8)
3.7
Surgery
Obstetrics and gynaecology
96 (8.7)
4.1
Other specialties
Family practice
4 (0.4)
4.2
Other specialties
Emergency medicine
1 (0.1)
4.3
Other specialties
Anaesthesiology
0
4.4
Other specialties
Dentistry
1 (0.1)
4.5
Other specialties
Pathology
2 (0.2)
4.6
Other specialties
Laboratory medicine
6 (0.5)
4.7
Other specialties
Dermatology
77 (7.0)
4.8
Other specialties
Radiology
8 (0.7)
5.1
Other clinical topics
Symptoms and signs and ill defined conditions
0
5.2
Other clinical topics
Toxicology or poisoning or substance misuse
2 (0.2)
5.3
Other clinical topics
Pharmacology or prescribing information
209 (19.0)
5.4
Other clinical topics
Physical diagnosis
0
5.5
Other clinical topics
Diagnostic process
0
5.6
Other clinical topics
Preventive medicine and screening
3 (0.3)
5.7
Other clinical topics
Nutrition
2 (0.2)
5.8
Other clinical topics
Patient education
1 (0.1)
6.1
Non-clinical topics
Medical ethics
3 (0.3)
6.2
Non-clinical topics
Legal issues
1 (0.1)
6.3
Non-clinical topics
Medical economics
2 (0.2)
6.4
Non-clinical topics
Anatomy
8 (0.7)
6.5
Non-clinical topics
Physiology
0
6.6
Non-clinical topics
Biochemistry
0
6.7
Non-clinical topics
Administrative issues
13 (1.2)
Most questions were assigned both a primary and secondary topic, but only the primary topics are listed here. For example, the question "Is there a support group for this patient going blind from macular degeneration?" has primary topic=ophthalmology, secondary topic=patient education.
Table w1 Taxonomy of generic questions
Identification No Categories Generic type No of questions (% of total of 1101) Primary Secondary Tertiary Quaternary 1.1.1.1 Epidemiology Prevalence or incidence What is the incidence or prevalence of condition X? or Why is the incidence or prevalence changing?
12 (1.1) 1.2.1.1 Epidemiology Risk factors Is X a risk factor for Y? 4 (0.4) 1.3.1.1 Epidemiology Course or prognosis What is the usual course of disease or condition X? or What is the prognosis of disease or condition X?
15 (1.4) 2.1.1.1 Diagnosis Cause of clinical finding Symptom What is the cause of symptom X? 94 (8.5) 2.1.2.1 Diagnosis Cause of clinical finding Sign What is the cause of physical finding X? 72 (6.5) 2.1.3.1 Diagnosis Cause of clinical finding Test finding (lab, ECG, imaging) What is the cause of test finding X? or How should I interpret test finding X?
45 (4.1) 2.1.4.1 Diagnosis Cause of clinical finding Unspecified findings or multiple categories of findings Could this patient have disease or condition X? or What does this patient have?
42 (3.8) 2.1.5.1 Diagnosis Cause of clinical finding Inconsistencies Why were this patient's findings (or disease course) inconsistent with usual expectations? 13 (1.2) 2.2.1.1 Diagnosis Test (lab, skin test, biopsy, imaging) Indications Is test X indicated in situation Y? or What test is indicated in situation Y?
41 (3.7) 2.2.2.1 Diagnosis Test (lab, skin test, biopsy, imaging) Timing When (in terms of timing) should I do test X? 5 (0.5) 2.2.3.1 Diagnosis Test (lab, skin test, biopsy, imaging) Performance How good is test X? or How good is test X in situation Y?
12 (1.1) 2.2.4.1 Diagnosis Test (lab, skin test, biopsy, imaging) Preparation What is the preparation for test X? 2 (0.2) 2.2.5.1 Diagnosis Test (lab, skin test, biopsy, imaging) Normal values What are the normal values for test X? 5 (0.5) 2.3.1.1 Diagnosis Name finding Body part (anatomy) on physical exam or imaging study What is the name of this body part? or What is the anatomy here?
8 (0.7) 2.3.2.1 Diagnosis Name finding Disease What is the name of that disease? 5 (0.5) 2.3.3.1 Diagnosis Name finding Test What is the name of that test? 2 (0.2) 2.4.1.1 Diagnosis Disease criteria What are the criteria for diagnosis of disease or condition X? or How do I diagnose condition X?
6 (0.5) 3.1.1.1 Treatment Drug prescribing Name finding What is the name of that drug that I'm trying to think of? 10 (0.9) 3.1.2.1 Treatment Drug prescribing Dosage What is the dose of drug X? 88 (8.0) 3.1.3.1 Treatment Drug prescribing Physical characteristics What are the physical characteristics (dosage forms, tablet or liquid characteristics, container characteristics) of drug X? 28 (2.5) 3.1.4.1 Treatment Drug prescribing When (or how) to start or stop When (or how) should I start or stop drug X? 19 (1.7) 3.1.5.1 Treatment Drug prescribing Adverse effects Findings caused by drug Could finding Y be caused by drug X? or Does drug X cause finding Y?
31 (2.8) 3.1.5.2 Treatment Drug prescribing Adverse effects What dose causes toxicity What dose of drug X would cause toxicity? 1 (0.1) 3.1.5.3 Treatment Drug prescribing Adverse effects Adverse effects of drug What are the adverse effects of drug X? 5 (0.5) 3.1.5.4 Treatment Drug prescribing Adverse effects Safety (includes safety in pregnancy and breast feeding) Is drug X safe to use in situation Y? 19 (1.7) 3.1.5.5 Treatment Drug prescribing Adverse effects Drug with fewest adverse effects Which drug has the fewest adverse effects? 3 (0.3) 3.1.6.1 Treatment Drug prescribing Interactions Is it OK to use drug X with drug Y? or Are there any interactions between drug X and drug (or food) Y?
21 (1.9) 3.1.7.1 Treatment Drug prescribing Indications Is drug X indicated in situation Y? or Is any drug indicated in situation Y?
36 (3.3) 3.1.8.1 Treatment Drug prescribing Contraindications Is drug X contraindicated in situation Y? 2 (0.2) 3.1.9.1 Treatment Drug prescribing Pharmacodynamics or absorption What are the pharmacodynamics or absorption characteristics of drug X? 3 (0.3) 3.1.10.1 Treatment Drug prescribing Drug of choice What is the drug of choice for condition X or in situation Y? 36 (3.3) 3.1.11.1 Treatment Drug prescribing Efficacy Does drug X work for condition Y? 21 (1.9) 3.1.12.1 Treatment Drug prescribing Cost Third party considerations What drug can I use in situation Y, given third party rules Y? 2 (0.2) 3.1.12.2 Treatment Drug prescribing Cost Cost comparison Is drug X cheaper than drug Y? 4 (0.4) 3.1.12.3 Treatment Drug prescribing Cost What is cost What is the cost of drug X? 2 (0.2) 3.1.13.1 Treatment Drug prescribing Serum levels What are the indications for getting a drug level or what time to draw or how often to draw? 3 (0.3) 3.1.14.1 Treatment Drug prescribing Orientation, help with recognition What is drug X? 16 (1.5) 3.1.15.1 Treatment Drug prescribing Composition What is in drug X? or How much of component X is in drug Y?
10 (0.9) 3.2.1.1 Treatment Not limited to drug prescribing Procedures How to do it How do you do procedure X? 3 (0.3) 3.2.1.2 Treatment Not limited to drug prescribing Procedures Efficacy What is the efficacy of procedure X? or Does procedure X work in situation Y?
5 (0.5) 3.2.2.1 Treatment Not limited to drug prescribing Principles of therapy What are the principles behind therapy X? 2 (0.2) 3.2.3.1 Treatment Not limited to drug prescribing Treatment for disease or condition How should I treat finding or disease X? or Should I use treatment Y for condition X?
75 (6.8) 3.2.4.1 Treatment Not limited to drug prescribing Practices of other physicians Why did physician X treat the patient this way? or How do other physicians manage condition X?
11 (1.0) 4.1.1.1 Management not limited to treatment Disease or finding or situation How should I manage disease or finding or situation X? (Not specifying diagnostic or therapeutic management) 78 (7.1) 4.2.1.1 Management not limited to treatment Aggressive or conservative How aggressive or conservative should I be in situation X? 17 (1.5) 4.3.1.1 Management not limited to treatment Compliance How can I get the patient or family to comply with my recommendations or agree with my assessment? 18 (1.6) 4.4.1.1 Management not limited to treatment Referral When do you refer is situation X? 6 (0.5) 4.5.1.1 Management not limited to treatment Patient education What patient education materials are available for situation X? 3 (0.3) 4.6.1.1 Management not limited to treatment Support or community groups Is there a support group or community group for condition X? 2 (0.2) 4.7.1.1 Management not limited to treatment Advise patient or family How should I advise the patient or family in situation X? 10 (0.9) 4.8.1.1 Management not limited to treatment Monitoring When (timing) should I do test X to monitor disease or condition Y? 11 (1.0) 5.1.1.1 Prevention Diagnostic screening test Indications Should this kind of patient have screening test X? or What screening tests should this patient have?
10 (0.9) 5.1.2.1 Prevention Diagnostic screening test Timing When (timing) or how often should screening test X be done? 9 (0.8) 5.1.3.1 Prevention Diagnostic screening test Efficacy What is the efficacy of screening test X? 2 (0.2) 5.2.1.1 Prevention Healthcare workers Is situation X dangerous for health care workers? 3 (0.3) 5.3.1.1 Prevention Indications for prophylactic treatment Should this kind of patient get prophylactic treatment X to prevent disease Y? or What prophylactic treatment should I give to prevent disease Y?
16 (1.5) 6.1.1.1 Ethics Financial Should I charge the patient in situation X? 1 (0.1) 6.2.1.1 Ethics Conflict of interest Is this situation a conflict of interest? 2 (0.2) 7.1.1.1 Physician-patient communication What is the best way to discuss or approach discussion of difficult issue X? 4 (0.4) 8.1.1.1 Etiology Cause of condition Why did the patient get disease or condition X? 4 (0.4) 8.2.1.1 Etiology Role of disease agent Can finding or disease agent X cause disease Y? or What are the causes of disease or condition Y?
17 (1.5) 8.3.1.1 Etiology Pathogenesis or mechanism How does disease X cause finding Y? or Can disease X cause finding Y?
11 (1.0) 8.4.1.1 Etiology Genetics Is disease or condition X hereditary? 2 (0.2) 9.1.1.1 Measurement unit conversion How do I convert from X units to Y units? 1 (0.1) 10.1.1.1 Education Medical students or residents How can I better teach this learner (resident, medical student)? 1 (0.1) 10.2.1.1 Education Continuing medical education I need to learn more about topic X. 10 (0.9) 10.3.1.1 Education Information source Where can I find information about topic X? 2 (0.2) 11.1.1.1 Frustration Generic type varies, not a true clinical question, rather an expression of frustration or an unanswerable dilemma 17 (1.5) 12.1.1.1 Unclassified Generic type varies, unable to classify. 5 (0.5)
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