PMID: 2107287Mar 1, 1990Paper

Diagnostic test restraint and the specialty consultation

Journal of General Internal Medicine
R L BrahamM E Charlson

Abstract

To assess the effect consultants had on the diagnostic process in the management of patients admitted to the medical service of a university hospital. Cohort study utilizing prospective evaluation by residents, retrospective chart review, and direct communication with the patient, a family member, or the patient's physician one year after admission to the hospital. The medical inpatient service of an urban university hospital. The 580 patients admitted to the medical service during one month in 1984 for whom complete data were available. Sixty-three percent of the patients had consultations. Seventy percent (198/284) of the patients admitted by generalists had consultations, while 57% (170/296) of the patients admitted by subspecialists had consultations. Of the 1,422 major diagnostic tests performed on these patients, 504 (35%) were first recommended by consultants, and the consultants recommended cancellation of only ten major diagnostic tests. Patients who were seen by consultants had a length of stay that was more than double that of patients not seen by consultants. Consultation was associated with prolonged stay when patients were stratified by important clinical variables and remained an important independent factor in a...Continue Reading

References

Dec 27, 1979·The New England Journal of Medicine·T W Moloney, D E Rogers
Jul 1, 1977·Journal of Medical Education·J M Eisenberg
Jan 1, 1986·Journal of Chronic Diseases·M E CharlsonR G Douglas
Jan 1, 1987·Journal of Chronic Diseases·M E CharlsonR G Douglas
Jan 30, 1986·The New England Journal of Medicine·M R ChassinD H Solomon
Nov 8, 1985·JAMA : the Journal of the American Medical Association·S R LowensteinM A Moskowitz
Sep 1, 1974·Journal of Chronic Diseases·M H Kaplan, A R Feinstein
Jul 10, 1980·The New England Journal of Medicine·C L Bosk
Jan 1, 1984·Medical Care·H P GreenwaldE B Perrin
Jan 1, 1983·The American Journal of Medicine·T LeeL Goldman
Jul 1, 1983·The American Journal of Medicine·M E CharlsonC L Sears
Jan 3, 1980·The New England Journal of Medicine·J NorenJ DeLozier
Dec 4, 1980·The New England Journal of Medicine·A R MartinE Braunwald

❮ Previous
Next ❯

Citations

Jul 1, 2005·Journal of General Internal Medicine·Mary E CharlsonJames P Hollenberg
Oct 30, 2008·BMC Research Notes·Michaela R JordanWilliam A Ghali
May 26, 1999·Journal of General Internal Medicine·M T DonohoeN Humphries
Jun 9, 2009·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Brian P LucasJulia L Bienias
Mar 14, 2018·Journal of Evaluation in Clinical Practice·Sunil H AdwaniKhalid Abusaada
Feb 28, 2003·Anesthesiology·Kyung W Park
Mar 28, 2017·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Kelly PacittiKim Jordan
Jan 5, 2019·Southern Medical Journal·Maribeth P WilliamsPeter J Carek
Mar 1, 1990·Journal of General Internal Medicine·E B Larson

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.