{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T05:10:33Z","timestamp":1773810633003,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,3,31]],"date-time":"2017-03-31T00:00:00Z","timestamp":1490918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale<\/jats:title><jats:p>Experienced primary care physicians handle most illnesses to everyone's satisfaction despite limited resources of time and means. However, cases can be multifaceted in that harmless\u2010presenting symptoms may also be warning signals or an indicator of a health disorder that too infrequently presents in family practice to be diagnosed correctly. On the basis of these observations, RN Braun developed 82 diagnostic protocols for a structured recording of various complaints.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>All consultations during the years 2001 to 2014, in which 1 author (WF) had used diagnostic protocols in her single\u2010handed practice, were analyzed retrospectively regarding reasons for encounter, diagnostic classification, and long\u2010term outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the period, a diagnostic protocol was used 1686 times. It was applied at a rate of approximately 5% of 2500 new complaints annually, most often (1366 times) for febrile conditions. In 320 consultations for other complaints, 43 different diagnostic protocols were applied. Among them, the \u201ctabula diagnostica\u201d for various undifferentiated symptoms was used most frequently (n\u00a0=\u00a054), followed by diagnostic protocols for headache (n\u00a0=\u00a045), dizziness (n\u00a0=\u00a036), precordial pain (n\u00a0=\u00a020), nonspecific abdominal pain (n\u00a0=\u00a015), low back pain (n\u00a0=\u00a014), hypertension (n\u00a0=\u00a012), diarrhea\u00a0&gt;\u00a01\u00a0week (n\u00a0=\u00a012), epigastralgia (n\u00a0=\u00a011), depression (n\u00a0=\u00a010), polyarthralgia (n\u00a0=\u00a08), cough, and lower abdominal pain (each n\u00a0=\u00a07). A final diagnosis was established in less than 20% of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This observational study from routine practice gives an insight how diagnostic protocols helped to manage complex patient presentations. A broader use of diagnostic protocols could investigate the potential of this consultation tool to handle the complexity of primary health care. The use of a standardized diagnostic approach could stimulate research, in particular on managing common complaints\/undifferentiated illness and their inherent diagnostic uncertainty.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.12710","type":"journal-article","created":{"date-parts":[[2017,3,31]],"date-time":"2017-03-31T12:23:12Z","timestamp":1490962992000},"page":"293-300","source":"Crossref","is-referenced-by-count":6,"title":["Diagnostic protocols\u2014A consultation tool still to be discovered"],"prefix":"10.1111","volume":"24","author":[{"given":"Waltraud","family":"Fink","sequence":"first","affiliation":[{"name":"Straning  Austria"},{"name":"Karl Landsteiner Institute for Systematics in General Medicine  Angern Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustav","family":"Kamenski","sequence":"additional","affiliation":[{"name":"Angern Austria"},{"name":"Department of General Practice, Center for Public Health Medical University Vienna  Austria"},{"name":"Karl Landsteiner Institute for Systematics in General Medicine  Angern Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Konitzer","sequence":"additional","affiliation":[{"name":"Schwarmstedt Germany"},{"name":"Academic Teaching Practice Hannover Medical School (MHH)  Hannover Germany"},{"name":"Karl Landsteiner Institute for Systematics in General Medicine  Angern Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1157"},{"key":"e_1_2_9_3_1","unstructured":"AitkenAM BraunRN FraillonJMG.Understanding general practice. Melbourne: Ed. The Victorian Academy for General Practice (conducted under the aegis of The Royal Australian College of General Practitioners \u2013 Victorian Faculty); 1982 ? 1985. Bookmark:http:\/\/trove.nla.gov.au\/version\/22813962"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijforecast.2009.05.023"},{"key":"e_1_2_9_5_1","unstructured":"https:\/\/oegam.at\/wissenschaft\/robert\u2010braun;http:\/\/www.karl\u2010landsteiner.at\/institutes\/systematics\u2010in\u2010general\u2010medicine.html"},{"key":"e_1_2_9_6_1","first-page":"1782","article-title":"Eine Methode zur prinzipiellen Verbesserung der Diagnostik in der Allgemeinpraxis","volume":"38","author":"Braun RN","year":"1960","journal-title":"MMW"},{"issue":"1","key":"e_1_2_9_7_1","first-page":"90","article-title":"Line and graph case records","volume":"10","author":"Reichenfeld HF","year":"1965","journal-title":"J Coll Gen Pract"},{"key":"e_1_2_9_8_1","first-page":"1320","article-title":"Versuch der Entwicklung einer lehrbaren Diagnostik f\u00fcr die Allgemeinpraxis II: Die diagnostische Erstberatung beim leichtkranken, unklar fiebernden Patienten, bei Luftwegekatarrhen und afebrilen bzw. Subfebrilen Allgemeinreaktionen. (attempt to develop a teachable diagnostics for general practice: The diagnostic approach at the first consultation in not severely ill, unclear febrile patients, in respiratory tract infections and nonfebrile or subfebrile general symptoms)","volume":"24","author":"Braun RN","year":"1964","journal-title":"Med Welt"},{"key":"e_1_2_9_9_1","volume-title":"Diagnostische Programme in der Allgemeinmedizin. (Diagnostic Protocols in General Practice)","author":"Braun RN","year":"1976"},{"issue":"4","key":"e_1_2_9_10_1","first-page":"337","article-title":"Perceived causes of family physicians' errors","volume":"40","author":"Ely JW","year":"1995","journal-title":"J Fam Pract"},{"issue":"2","key":"e_1_2_9_11_1","first-page":"50","article-title":"Organizing diagnosis in general practice","volume":"12","author":"Braun RN","year":"1965","journal-title":"World Med J"},{"key":"e_1_2_9_12_1","volume-title":"Angewandte Medizin \u2013 Wissenschaftliche Grundlagen. (Applied Medicine \u2010 Scientific Bases)","author":"Braun RN","year":"2004"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12113"},{"issue":"11","key":"e_1_2_9_14_1","first-page":"970","article-title":"Is your practice really that predictable? Nonlinearity principles in family medicine","volume":"54","author":"Katerndahl DA","year":"2005","journal-title":"J Fam Pract"},{"key":"e_1_2_9_15_1","volume-title":"Programmierte Diagnostik in der Allgemeinmedizin. 82 Checklisten f\u00fcr Anamnese und Untersuchung. (Diagnostics by Protocols in General Practice. 82 Checklists for history, physical examination and testing)","author":"Braun RN","year":"2005"},{"issue":"4","key":"e_1_2_9_16_1","first-page":"263","article-title":"Diagnostische Programme nach R.N.Braun. Was hindert den Allgemeinarzt, programmiert zu untersuchen? (R. N. Braun diagnostic programs: What prevents the general practitioner from using them? Results of a 1\u2010year\u2010study of indications, acceptance and failure to apply diagnostic programs)","volume":"92","author":"Fink W","year":"1998","journal-title":"Z Arztl Fortbild Qualitatssich"},{"issue":"5","key":"e_1_2_9_17_1","first-page":"4","article-title":"A different way of doctoring","volume":"17","author":"Carmichael LP","year":"1985","journal-title":"Fam Med"},{"key":"e_1_2_9_18_1","first-page":"1351","article-title":"Suggested guidelines for the family medicine case report","volume":"36","author":"Morris BA","year":"1990","journal-title":"Can Fam Physician"},{"issue":"4","key":"e_1_2_9_19_1","first-page":"261","article-title":"The use of standardized patients to evaluate family medicine resident decision making","volume":"39","author":"Terry R","year":"2007","journal-title":"Fam Med"},{"key":"e_1_2_9_20_1","first-page":"117","volume-title":"Epidemiology and Primary Medical Care","author":"Braun RN","year":"1977"},{"issue":"1","key":"e_1_2_9_21_1","first-page":"16","article-title":"The essence of general practice","volume":"11","author":"Braun RN","year":"1965","journal-title":"World Med J"},{"issue":"3","key":"e_1_2_9_22_1","first-page":"83","article-title":"Was leistet die intuitive Diagnostik beim Herzschmerz? (What does the intuitive diagnostic approach in precordial pain?)","volume":"100","author":"Braun RN","year":"1988","journal-title":"Wien Klin Wochenschr"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.314.7088.1170"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.t01-1-00003"},{"key":"e_1_2_9_25_1","volume-title":"Lehrbuch der \u00e4rztlichen Allgemeinpraxis","author":"Braun RN","year":"1970"},{"key":"e_1_2_9_26_1","volume-title":"Braun Kasugraphie: (K)ein Fall wie der andere... Benennung und Klassifikation der regelm\u00e4\u00dfig h\u00e4ufigen Gesundheitsst\u00f6rungen in der prim\u00e4r\u00e4rztlichen Versorgung. (Braun Kasugraphy: (Not)one case like the other \u2026 Labelling and classification of the regular frequent health disorders in primary care)","author":"Braun RN(\u2020)","year":"2010"},{"key":"e_1_2_9_27_1","unstructured":"RosowskyO AndralJ CitteeJ.Le management des troubles de sant\u00e9 en m\u00e9decine de ville. Une gestion raisonn\u00e9e de la sc\u00e8ne du danger. (The management of health problems in general practice. A rational management of the scene of danger)Edit\u00e9 avec le soutien de M.G\u00e9rald de Pouvourville C.R.E.G.A.S. \u2013 INSERM;2002."},{"issue":"2","key":"e_1_2_9_28_1","first-page":"121","article-title":"Zur Notwendigkeit einer Methodik abgestuften Diagnostik in der Allgemeinmedizin als Konsequenz des Bayes'schen theorems. (Stepwise diagnostic workup in general practice as a consequence of the Bayesian reasoning)","volume":"100","author":"Schneider A","year":"2006","journal-title":"Z Arztl Fortbild Qualitatssich"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-10-12"},{"key":"e_1_2_9_30_1","unstructured":"BraunRN.Heilung f\u00fcr die Heilkunde. Die Geschichte einer Entdeckung. Wissenschaftliche Autobiographie. (A cure for medicine. The story of a discovery. Scientific Autobiography)Sign.: Cod. Ser. n. 38768 Samml.: Han Wien \u00d6NB Austrian National Library (bequest unpublished);1991\u20101992."},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1593"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.5768"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjep.12710","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.12710","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jep.12710","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.12710","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T01:10:48Z","timestamp":1694394648000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.12710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,31]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1111\/jep.12710"],"URL":"https:\/\/doi.org\/10.1111\/jep.12710","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"value":"1356-1294","type":"print"},{"value":"1365-2753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,31]]}}}