Use of multiple inflammatory marker tests in primary care: using Clinical Practice Research Datalink to evaluate accuracy

While being a useful reminder that sick folk can have normal tests and vice versa, the article misses the point that many (most?) GPs will use inflammatory markers as the concluding part of a cascade, not the begin and end of it.

 

A patient with an unconcerning history, normal examination findings and normal inflammatory markers is a patient with a high likelihood of being actually well. In absence of sharper tests for being physically well (even if worried) such cascades remain the norm and rightly so for filtering the sick or potentially sick from those we can reassure. On the other side, worrying findings or history are clearly not assuaged by a normal CRP on its own.