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首页> 外文期刊>Family practice. >Managing uncertainty: a qualitative study of GPs' views on the diagnosis and immediate management of transient ischaemic attack and the potential of a diagnostic tool
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Managing uncertainty: a qualitative study of GPs' views on the diagnosis and immediate management of transient ischaemic attack and the potential of a diagnostic tool

机译：管理不确定性：对GPS对诊断和立即管理瞬态缺血攻击的定性研究以及诊断工具的潜力

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Background. Most patients with transient ischaemic attack (TIA) present to their GP. Early identification and treatment reduces the risk of subsequent stroke and consequent disability and mortality.Objective. To explore GPs' views on the diagnosis and immediate management of suspectedTIA, and the potential utility of a diagnostic tool.Methods. This is a qualitative interview study based in Leicestershire, UK. A purposive sample of 10 GPs participated in 30-minute semi-structured telephone interviews. Data were analysed thematically.Results. GPs reported that TIA was more likely to be suspected when patients were more obvious candidates for TIA based on their history, characteristics and symptom presentation. Referrals were in part a strategy to manage risk under conditions of uncertainty and to seek reassurance. GPs valued using aTIA risk stratification tool but felt this did not inform their diagnostic decision making. A diagnostic tool forTIA in primary care was seen to have potential to improve the decision-making process about diagnosis and management and enhance confidence of GPs, particularly in ruling outTIAs. GPs saw benefits of using hard thresholds, but remained concerned about missing TIAs and saw a tool as an adjunct to clinical judgement.Conclusions. GPs weigh up the likelihood of TIA in the context of assessments of candidacy and diverse, often vague, symptoms. A diagnostic tool could support GPs in this process and help reduce reliance on referrals to TIA clinics for reassurance, provided the tool was designed to support decision making in cases of less 'typical' presentations.
机译：背景。大多数患有短暂性缺血攻击（TIA）的患者呈现给他们的GP。早期鉴定和治疗可降低随后的中风和随从的残疾和死亡率的风险。目的。探索GPS对诊断和立即管理疑似的看法，以及诊断工具的潜在效用。方法。这是英国莱斯特郡的定性面试学习。 10 GPS的有目的样本参加了30分钟的半结构性电话访谈。主题分析数据。结果。 GPS报告称，当患者基于其历史，特征和症状介绍时，患者对TIA更明显的候选人，TIA更有可能怀疑。推荐部分是在不确定性条件下管理风险并寻求保证的策略。 GPS使用ATIA风险分层工具进行了价值，但觉得这并没有告知他们的诊断决策。初级保健中的诊断工具是巨大的初级保健工具，有可能改善关于诊断和管理的决策过程，并提高GPS的置信度，特别是在统治外部。 GPS出现了使用硬阈值的好处，但仍然涉及缺失的蒂亚斯并看到一个工具作为临床判断的辅助工具.Conclusions。 GPS在评估候选和多样化的情况下，重量TIA的可能性，通常模糊，症状。诊断工具可以支持此过程中的GPS，并有助于减少对TIA诊所进行保证的引用，因为该工具旨在支持在较少“典型”演示文稿的情况下的决策。

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