Significance and Potential of Diagnostic Algorithms in Primary Care

german translation / full article

Julian Wangler, Sophie Pillath, Michael Jansky

Keywords: diagnostic algorithm differential diagnostics evidence-based medicine family medicine medical clarification

Background: Diagnostic algorithms are designed to help primary care physicians to work their way forward to a possible diagnosis based on a leading symptom. While the use and exploration of diagnostic algorithms is widespread in clinical contexts, little is known about the significance they have for the primary care perspective, how much they are used, and where difficulties might exist.Methods: In the course of a survey, 403 family physicians in Hesse and Thuringia were interviewed (survey period: September–October 2018). Due to the explorative approach of the study only a descriptive analysis was performed.Results: Two thirds (66 %) of the interviewees considers diagnostic algorithms in principle as useful tools in daily clinical practice; 24 % sees no benefit. 41 % use such aids regularly in everyday practice. Due to difficulties to catch up with the numbers of available algorithms, there is a high degree of uncertainty in estimating the quality and reliability of such instruments. In addition, algorithms are not always easy to use and cost-covering. If these reservations are taken up, most respondents would be willing to integrate algorithms into patient care in the future.Conclusions: In order to address the concerns and uncertainties of primary care physicians with respect to diagnostic algorithms, the development of future algorithms should ensure the greatest possible application proximity for primary care. At the same time, room for maneuvering should be retained for family physicians, and proposed diagnostic measures should be strictly cost-covering.

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