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. Author manuscript; available in PMC: 2012 Dec 1.
Published in final edited form as: J Eval Clin Pract. 2010 Jul 13;17(6):1122–1128. doi: 10.1111/j.1365-2753.2010.01489.x

Table 1. Symptoms (and distractions) Embedded in Two Clinical Scenarios: A case representing undiagnosed diabetes and a case of diabetes with peripheral neuropathy.

Undiagnosed Case Symptoms Diagnosed Case Symptoms

  • Thirst

  • Fatigue

  • Frequent urination

  • Non-intentional weight loss for more than 5 months without changing diet

  • Not feeling well

  • Overweight

  • Burning in feet

  • Bottoms of feet and up one ankle

  • Intermittent

  • Hard to localize

  • Overweight
Distractions Distractions

  • Patient concern about heart disease

  • High blood pressure (135/95)

  • Drinking a lot of caffeine

  • Hasn't been to doctor in several years

  • Patient concern about high blood pressure

  • On blood pressure medication, but compliance less than ideal

  • Single high blood pressure reading (145/98)

  • HbA1c = 6.9

Note: Since patients seldom present as ‘textbook cases’ minor distractions were also embedded to increase the clinical authenticity of the clinical scenarios.