[An analysis of the discrepancies in the diagnosis of cancer in the Stavropol' district (according to the findings of the boards of hospitals in the city of Stavropol')].
[Development of criteria for assessing the quality of microbiological studies and for evaluating their efficiency in tuberculosis service facilities and the general health network].
The major available indicators of the efficiency of laboratory service activities in diagnosing tuberculosis, including those widely used in international practice and Russian traditional tuberculosis statistical data, are analyzed. The optimal criteria for assessing the quality and efficiency of work of the clinical diagnostic laboratories of the general health network and the bacteriological laboratories of a tuberculosis service in the detection, diagnosis, and chemotherapy monitoring of tuberculosis have been developed. The recommended levels of the indicators, which are to be achieved by well working laboratories, if a well-implemented tuberculosis-controlling program is available, are defined.
OBJECTIVE: To explore the medically unexplained disorders by examining endpoints of irresolute diagnostic strategies. DESIGN: Qualitative observational study based on audio-taped general practice consultations, editing analysis style inspired by Giorgi's phenomenological approach. SETTING: Primary health care. SUBJECTS: Purposeful sampling of 17 consultations containing diagnostic conclusions, but no clear-cut diagnosis drawn from a total of 86 consultations with women patients in general practice. MAIN OUTCOME MEASURES: Descriptions of diagnostic conclusions in consultations when clear-cut diagnoses are not obtained. RESULTS: We identified three types of diagnostic conclusions.The first conveys assurances that nothing dangerous is suspected. The doctors find that the symptoms somehow look like a diagnosis, and further investigation can be initiated. In the second group, the symptoms lead the doctors to test management, and take the outcome as material for further assessment. The third type of conclusion implies a decision to track cues of potential danger, quick settlements, although the seriousness of the situation is not necessarily communicated to the patient. CONCLUSION: Exploration of diagnostic work in general practice can provide access to understand what goes on when patients are given the label of "unexplained" disorders.
The quality of the sickness certificate. A case control study of patients with symptom and disease specific diagnoses in primary health care in Sweden.
Objective: To compare information in sickness certificates and rehabilitation activities for patients with symptom diagnoses vs patients with disease specific diagnoses. Design: Retrospective case control study 2013-2014. Setting: Primary health care, Sweden. Subjects. Patients with new onset sickness certificates with symptom diagnoses n?=?222, and disease specific diagnoses (controls), n?=?222. Main outcome measures: Main parameters assessed were: information about body function and activity limitation in certificates, duration of sick leave, certificate renewals by telephone, diagnostic investigations, health care utilisation, contacts between patients, rehabilitation coordinators, social insurance officers, employers and occurrence of rehabilitation plans. Results: Information about body function and activity limitation was sufficient according to guidelines in half of all certificates, less in patients with symptom diagnoses compared to controls (44% vs. 56%, p?=?0.008). Patients with symptom diagnoses had shorter sick leave than controls (116 vs. 151 days p?=?0.018) and more certificates issued by telephone (23% vs. 15% p?=?0.038). Furthermore, they underwent more diagnostic investigations (32% vs. 18%, p?
To estimate circulatory diseases (CD) detection rates during prophylactic medical examination of the adult population and to define their association with mortality rates and the spread of risk factors.
The results of the 2013-2014 prophylactic medical examinations for CD in the adult population of the Russian Federation as a whole and its subjects were comparatively analyzed using the data of statistical reports and official medical statistics on morbidity and mortality in the adult population.
The data of official statistical reports on the results of prophylactic medical examinations in 2013 (19.4 million) and 2014 (22.2 million) were analyzed. In 2013 and 2014, there were 85.9 and 82.7 CD cases per 1000 examinees, respectively. These years were marked by the detection of 50.0 and 46.2 hypertensive patients, 17.1 and 16.1 coronary heart disease (CHD) cases, and 11.5 and 11.2 cerebrovascular diseases (CVD) ones, respectively. In 2013 and 2014, most CD cases were caused by hypertension (58.4 and 57%, respectively). The proportion of CHD was 19.9 and 19.4% and that of CVD was 13.4 and 13.6%, respectively.
The analysis carried out could provide evidence for the importance of continuous monitoring of prophylactic medical examination at the level of each specific healthcare facility for primary health care to improve its quality and completeness of diagnostic examination. The found interregional differences in the detection rate of CD call for detailed analysis and determination of their causes, which will ensure the preventive direction of a medical examination that is inextricably entwined with further active follow-up measures for patients having the identified diseases and a risk for their development.
