Abstract
In interpreting diagnostic information the differences between morbidity patterns in general practice and those in hospitals must be taken into consideration. This article demonstrates the importance of prevalence for predictive values of complaints, symptoms and test results. When the general practitioner refers patients to the specialist, these values may change, and it is also possible that associations between symptoms and diagnoses are distorted by selection bias. Moreover, attention must be paid to the differences in clinical stages encountered in general practice and specialist practice. It is concluded that a large part of the `diagnostic field' of general practice has still to be discovered and developed.
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Selected References
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- Clarijs W. W., van Deelen-Willems M., Hendriks J. H., Lubbers E. J., Schmidt W. J. Het occulte mammacarcinoom. Ned Tijdschr Geneeskd. 1977 Mar 26;121(13):526–529. [PubMed] [Google Scholar]
- Elwood P. C., Waters W. E., Greene W. J., Sweetnam P., Wood M. M. Symptoms and circulating haemoglobin level. J Chronic Dis. 1969 Feb;21(9):615–628. doi: 10.1016/0021-9681(69)90034-4. [DOI] [PubMed] [Google Scholar]
- Garby L. The normal haemoglobin level. Br J Haematol. 1970 Oct;19(4):429–434. doi: 10.1111/j.1365-2141.1970.tb06970.x. [DOI] [PubMed] [Google Scholar]
- Hennemann G., Smeulers J. [Is there room for individual iodine supplementation as prevention for goiter?]. Ned Tijdschr Geneeskd. 1977 Jun 4;121(23):955–956. [PubMed] [Google Scholar]
- Molenaar J. C., den Herder-Kroon B. De praktische waarde van de mammografie voor de chirurg. Ned Tijdschr Geneeskd. 1970 Oct 10;114(41):1688–1690. [PubMed] [Google Scholar]
- Ransohoff D. F., Feinstein A. R. Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. N Engl J Med. 1978 Oct 26;299(17):926–930. doi: 10.1056/NEJM197810262991705. [DOI] [PubMed] [Google Scholar]
- Rümke C. L. Kanttekeningen over de gevoeligheid, de specificiteit en de voorspellende waarden van diagnostische tests. Ned Tijdschr Geneeskd. 1983 Mar 26;127(13):556–561. [PubMed] [Google Scholar]
- Watt C. M. The estimation of haemoglobin and the diagnosis of anaemia in general practice. Practitioner. 1972 Aug;209(250):218–222. [PubMed] [Google Scholar]
- de Dombal F. T. Acute abdominal pain--an O.M.G.E. survey. Scand J Gastroenterol Suppl. 1979;56:29–43. [PubMed] [Google Scholar]