{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T20:55:36Z","timestamp":1763499336004},"reference-count":35,"publisher":"Royal College of General Practitioners","issue":"658","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>One of the tenets of general practice is that continuity of care has a beneficial effect on patient care. However, little is known about how continuity can have an impact on the diagnostic reasoning of GPs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore GPs\u2019 diagnostic strategies by examining GPs\u2019 reflections on their patients\u2019 individual thresholds for seeking medical attention, how they arrive at their estimations, and which conclusions they draw.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Qualitative study with 12 GPs in urban and rural practices in Germany.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>After each patient consultation GPs were asked to reflect on their diagnostic reasoning for that particular case. Qualitative and quantitative analyses of consultations and interview content were undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 295 primary care consultations were recorded, 134 of which contained at least one diagnostic episode. When elaborating on known patients, GPs frequently commented on how \u2018early\u2019 or \u2018late\u2019 in an illness progression a patient tended to consult. The probability of serious disease was accordingly regarded as high or low. This influenced GPs\u2019 behaviour regarding further investigations or referrals, as well as reassurance and watchful waiting. GPs\u2019 explanations for a patient\u2019s utilisation threshold comprised medical history, the patient\u2019s characteristics, family background, the media, and external circumstances.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The concept of an individual threshold for the utilisation of primary care would explain how GPs use their knowledge of individual patients and their previous help-seeking behaviour for their diagnostic decision making. Whether the assumption behind this concept is valid, and whether its use improves diagnostic accuracy, remains to be investigated.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp17x690509","type":"journal-article","created":{"date-parts":[[2017,4,11]],"date-time":"2017-04-11T01:05:16Z","timestamp":1491872716000},"page":"e361-e369","source":"Crossref","is-referenced-by-count":6,"title":["Individual utilisation thresholds and exploring how GPs\u2019 knowledge of their patients affects diagnosis: a qualitative study in primary care"],"prefix":"10.3399","volume":"67","author":[{"given":"Matthias","family":"Michiels-Corsten","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"B\u00f6sner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Donner-Banzhoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1987","published-online":{"date-parts":[[2017,4,10]]},"reference":[{"key":"2020081209301763000_67.658.e361.1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmg601"},{"key":"2020081209301763000_67.658.e361.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7425.1219"},{"issue":"4","key":"2020081209301763000_67.658.e361.3","doi-asserted-by":"crossref","first-page":"290","DOI":"10.3109\/02813439209014076","article-title":"The influence of general practitioners\u2019 knowledge about their patients on the clinical decision-making process","volume":"10","author":"Hjortdahl","year":"1992","journal-title":"Scand J Prim Health Care"},{"key":"2020081209301763000_67.658.e361.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.303.6811.1181"},{"key":"2020081209301763000_67.658.e361.5","doi-asserted-by":"crossref","unstructured":"Maarsingh OR Henry Y van de Ven PM Deeg DJ (2016) Br J Gen Pract, Continuity of care in primary care and association with survival in older people: a 17-year prospective cohort study. 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