Abstract:
OBJECTIVE:To determine whether abnormal results for liver function tests are investigated in primary care and findings on full investigation. DESIGN:Retrospective audit and prospective clinical investigation. SETTING:University hospital and surrounding general practices serving around 330 000 people. SUBJECTS:Adults with abnormal results for liver function based on tests requested by their doctor between 1 January and 30 June 1995. INTERVENTIONS:All patients with gamma-glutamyltransferase, alanine aminotransferase, or alkaline phosphatase concentrations at least twice the upper limit of the reference range were studied. A median of 15 months later (range 12-21) records of hospital attendances and further investigations were examined. Where investigations were incomplete the records from the general practice were examined, and suitable patients were invited to attend the liver clinic. MAIN OUTCOME MEASURES:Investigations requested by the doctor and final diagnoses reached. RESULTS:933 patients with abnormal liver function tests were identified; follow up data were obtained in 873 (94%). 531 patients were already under hospital review. Of the remaining 342 patients, 157 were suitable for investigation; the others had died, moved away, were elderly, or had repeat liver function tests with normal results. No further tests were requested for 91 (58%) of these patients. 66 had been partially investigated by their doctor, and in seven patients results suggesting a treatable chronic liver disease had not been followed up. On investigation, 97 (62%) had an identifiable diagnosis requiring hospital intervention or follow up, or both. CONCLUSIONS:Abnormal results for liver function are often not adequately investigated, missing an important chance of identifying treatable chronic liver disease.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Sherwood P,Lyburn I,Brown S,Ryder Sdoi
10.1136/bmj.322.7281.276keywords:
subject
Has Abstractpub_date
2001-02-03 00:00:00pages
276-8issue
7281eissn
0959-8138issn
1756-1833journal_volume
322pub_type
杂志文章abstract::On 1 April the Department of Health introduced the mandatory collection of data on the ethnic group of patients admitted to hospital. Its coding was based on a national minimum standard for classifying ethnic groups, ostensibly using the categories in the 1991 census. In the census, however, one in four people from et...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
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更新日期:1995-10-14 00:00:00
abstract:OBJECTIVE:To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN:Longitudinal analysis. SETTING:35 medical facilities of Kaiser Permanente Northern California, 1997-2007. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1990-12-15 00:00:00
abstract:OBJECTIVE:To assess the association of lichen planus with liver complaints and with known aetiological factors of liver diseases. DESIGN:Multicentre case-control study. Interviews were conducted by trained medical investigators on the basis of a structured questionnaire. At the interview patients and controls were ask...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:1990-01-27 00:00:00
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更新日期:2013-02-12 00:00:00
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
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abstract:OBJECTIVE:To determine whether the author's 20.9 lb (9.5 kg) carbon frame bicycle reduced commuting time compared with his 29.75 lb (13.5 kg) steel frame bicycle. DESIGN:Randomised trial. SETTING:Sheffield and Chesterfield, United Kingdom, between mid-January 2010 and mid-July 2010. PARTICIPANTS:One consultant in an...
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pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c6801
更新日期:2010-12-09 00:00:00
abstract::The studyEveritt H, Landau G, Little P. Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT. Health Technol Assess 2019;23:1-154.This project was funded by the NIHR Health Technology Assessment Programme (project number 11...
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pub_type: 评论,杂志文章
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更新日期:2019-11-04 00:00:00
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pub_type: 杂志文章
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更新日期:2004-11-13 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2005-04-16 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.f7661
更新日期:2014-01-13 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2004-03-27 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2015-07-28 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c2220
更新日期:2010-05-17 00:00:00
abstract::To assess the prevalence of both diagnosed and undiagnosed diabetes mellitus in an area of predominantly Asian population the Coventry diabetes study is carrying out house to house screening for diabetes in people aged 20 and over in Foleshill, Coventry. In the first five of 12 areas to be studied 2130 of 2283 Asian (...
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pub_type: 杂志文章
doi:10.1136/bmj.298.6665.18
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pub_type: 杂志文章,meta分析,评审
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更新日期:2006-05-13 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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更新日期:2010-09-10 00:00:00
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更新日期:2012-10-15 00:00:00
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pub_type: 杂志文章
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更新日期:2017-03-14 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.303.6795.161
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.320.7246.1380
更新日期:2000-05-20 00:00:00
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更新日期:2015-09-20 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.309.6946.15
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7172.1564
更新日期:1998-12-05 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.305.6861.1074
更新日期:1992-10-31 00:00:00