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Uncertain diagnostic language affects further studies, endoscopies, and repeat consultations for patients with functional gastrointestinal disorders.

Linedale, Ecushla C, Chur-Hansen, Anna, Mikocka-Walus, Antonina, Gibson, Peter R and Andrews, Jane M 2016, Uncertain diagnostic language affects further studies, endoscopies, and repeat consultations for patients with functional gastrointestinal disorders., Clinical gastroenterology and hepatology, vol. 14, no. 12, pp. 1735-1741.e1, doi: 10.1016/j.cgh.2016.06.030.

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Title Uncertain diagnostic language affects further studies, endoscopies, and repeat consultations for patients with functional gastrointestinal disorders.
Author(s) Linedale, Ecushla C
Chur-Hansen, Anna
Mikocka-Walus, Antonina
Gibson, Peter R
Andrews, Jane M
Journal name Clinical gastroenterology and hepatology
Volume number 14
Issue number 12
Start page 1735
End page 1741.e1
Total pages 8
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-12
ISSN 1542-7714
Keyword(s) Communication
Endoscopy
IBS
Management
Summary BACKGROUND & AIMS: Although guidelines state that functional gastrointestinal disorders (FGIDs) can be diagnosed with minimal investigation, consultations and investigations still have high costs. We investigated whether these are due to specific behaviors of specialist clinicians by examining differences in clinician approaches to organic gastrointestinal diseases vs FGIDs. METHODS: We performed a retrospective review of 207 outpatient department letters written from the gastroenterology unit at a tertiary hospital after patient consultations from 2008 through 2011. We collected data from diagnostic letters and case notes relating to patients with organic (n = 108) or functional GI disorders (n = 119). We analyzed the content of each letter by using content analysis and reviewed case files to determine which investigations were subsequently performed. Our primary outcome was the type of diagnostic language used and other aspects of the clinical approach. RESULTS: We found gastroenterologists to use 2 distinct types of language, clear vs qualified, which was consistent with their level of certainty (or lack thereof), for example, "the patient is diagnosed with…." vs "it is possible that this patient might have….". Qualified diagnostic language was used in a significantly higher proportion of letters about patients with FGIDs (63%) than organic gastrointestinal diseases (13%) (P < .001). In addition, a higher proportion of patients with FGIDs underwent endoscopic evaluation than patients with organic gastrointestinal diseases (79% vs 63%; P < .05). CONCLUSIONS: In an analysis of diagnoses of patients with FGIDs vs organic disorders, we found that gastroenterologists used more qualified (uncertain) language in diagnosing patients with FGIDs. This may contribute to patient discard of diagnoses and lead to additional, unwarranted endoscopic investigations.
Language eng
DOI 10.1016/j.cgh.2016.06.030
Field of Research 110307 Gastroenterology and Hepatology
111714 Mental Health
110399 Clinical Sciences not elsewhere classified
Socio Economic Objective 920105 Digestive System Disorders
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30089550

Document type: Journal Article
Collection: School of Psychology
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