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- Page navigation anchor for Repeat inflammatory marker testing - authors replyRepeat inflammatory marker testing - authors replyThank you to Hassan for pointing out the importance of taking into account the trend in inflammatory markers when interpreting test results. In table 1 of the linked paper1 weShow More
were able to look at the impact of repeat testing, and we can share further details of this analysis for clarification. Patients with an initial raised inflammatory marker which subsequently returned to normal had a lower overall incidence of disease at 18.6% compared to those with persistently raised inflammatory markers where overall disease incidence was 23.8%. Subdividing further for the most commonly used test, CRP, we found that a second abnormal test which is higher than the first (rising trend) had the highest overall disease incidence at 26.6%; those with a second abnormal test which was lower than the first but still above the upper limit of normal (stable or falling trend) had a dise...Competing Interests: None declared. - Page navigation anchor for Use of multiple inflammatory marker tests in primary care: using Clinical Practice Research Datalink to evaluate accuracyUse of multiple inflammatory marker tests in primary care: using Clinical Practice Research Datalink to evaluate accuracyThanks to Jessica Watson et al1 for their very useful research paper. This touches on one aspect of the very topical issue of over investigation. This is a real problem which sometimes gives the impression that
investigations are used as a substitute to a thorough history and examination.I would like to know if forShow Morethe purposes of this research, when assessing the predictive value of current raised inflammatory markers,...Competing Interests: None declared. - Page navigation anchor for Only part of a cascadeOnly part of a cascadeWhile 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 anShow More
unconcerning history, normal examination findings and normal inflammatory markers is a patient with a high likelihood of beingactually 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, worry...Competing Interests: None declared.