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At the heart of general practice since 1960

New GP diagnostic support tool improves accuracy, finds study

A diagnostic aid providing early support to GPs during the initial stages of patient consultation improved their diagnostic accuracy, according to a recent study.

The diagnostic support system (DSS) tool requires GPs to enter an initial reason for the patient seeking a consultation, and then displays a list of possible diagnoses based on the patient’s age and sex.

As more symptoms are added to the tool, the list of diagnoses is reordered based on the amount of information supplied and the diagnostic incidence of each condition.

The study, carried out by researchers at the University of Dundee, found that when 34 GPs used the tool in simulated clinical scenarios, with actors playing patients, there was an 8% absolute increase in diagnostic accuracy to 58%, compared with 50% when they used their own judgement.

The researchers said that while the precise psychological mechanisms through which the DSS works, and its impact on cognition, are not known, it is possible the tool ‘has a debiasing effect by disrupting intuitive thinking based on first impressions, and encourages a more reflective or cautious approach’.

The GPs did not spend longer in consultations or order more tests when using the tool and reported they were satisfied with the tool’s ‘usability’. In addition, patient satisfaction ratings were similar between consultations with and without the DSS, leading the authors to state that they found ‘no evidence’ for the use of such tools affecting the doctor-patient relationship.

The GPs also added significantly more data into the patients’ notes when using the DSS, as the tool’s integration with the electronic health record system allowed information to be coded in real time.

The team concluded that the tool 'has the potential to be employed successfully, and lead to improved coding, diagnosis, and management, without significant costs in time, tests, and patient satisfaction'.

Br J Gen Pr 2017; available online 30 January

Readers' comments (7)

  • ROBODOC!

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  • Spuds

    Oh do just sod off now and stop coming up with new ways of ruining our jobs.

    I like to talk to my patients - if I wanted algorithms I'd work for NHS24

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  • easy to get the answer right when you know it before you start. lets see some real lived experience before we get all dewy eyed over this

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  • Just like MRCGP ie done with actors.And divorced from reality.Maybe I've got it all wrong but I thought history and examination were both vital to establishing a diagnosis.

    I wonder how the tool would handle the following:

    "Dr DGAF, the PIP people told me to come to see you because you can do me a letter to help with my claim".

    DGAF-"Are you still drinking 2L of cider each day? Alcohol problems was on your sicknotes, wasn't it?"

    "Yes.I've tried to stop but it's hard.I drink because I can't sleep and you won't give me those temazzies".

    DGAF-"Did you get in touch with the Alcohol services we chatted about last time?"

    "I couldn't afford the bus money so I missed the appointment".

    I hope the tool can help me code this interaction.........

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  • "THEY TOOK OUR JOBS!!!!!!!!"

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  • Great to see you still working doctor.
    I don't waste doctors time .
    How is the mechanic work ..you know my receptionist said you did a good job on her car.
    Great, but I need a letter for pip and mobility car
    What is the issue.
    Pain in back and all over. Can you write .....

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  • Knowledge is Porridge

    I know this isn't 1-2 years away, but sometime soon a lot of our work is going to be handed to an intelligent computer.
    I dont think we are going to be jobless, but I do think we have reasons for optimism when facing an aging and complex population against flat resources.
    But at the moment I just get an infuriating pop up every time I document the word fever alerting me to the possibility of sepsis.
    As an interim measure, can someone design me a program to extract 2 useful sentences out of every 111 notification, while removing all the "the patient is breathing" garbage.

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