A Mathematical Theory of Primary Care
Eine mathematische Theoriegerman translation / full article
Summary: We suggest that entropy as defined by Shannon and Weaver is a useful measure for uncertainty in primary care. Primary care clinicians work at the interface between the lifeworld and the health care system. With their unselected patients they have to confront situations with maximal diagnostic uncertainty. Based on a study of chest pain in primary care we show that primary care physicians reduce uncertainty effectively by an adequate history incorporating the prevalence of relevant conditions. The contribution of specialties operating on a referral basis is much smaller. Information theory and entropy as a measure of uncertainty have implications for study design since it allows evaluation of diagnostic tests regarding several diseases instead of just one. The concept will also contribute to the more profound understanding of issues such as quality management, the division of labour in primary care practice and the study of modern bureaucratic systems.