title: The interpretation of the reasons for encounter 'cough' and 'sadness' in four international family medicine populations.
abstract: BACKGROUND
  This is a study of the relationships between common reasons for encounter (RfEs) and common diagnoses (episode titles) within episodes of care (EoCs) in family practice populations in four countries.
  
  
  METHODS
  Participating family doctors (FDs) recorded details  of all their patient contacts in an EoC structure using the International Classification of Primary Care (ICPC), including RfEs presented by the patient, and the FDs' diagnostic labels. The relationships between RfEs and episode titles were studied using Bayesian methods.
  
  
  RESULTS
  The RfE 'cough' is a strong, reliable predictor for the diagnoses 'cough' (a symptom diagnosis), 'acute bronchitis', 'URTI' and 'acute laryngitis/tracheitis' and a less strong, but reliable predictor for 'sinusitis', 'pneumonia', 'influenza', 'asthma', 'other viral diseases (NOS)', 'whooping  cough', 'chronic bronchitis', 'wheezing' and 'phlegm'. The absence of cough is a weak but reliable predictor to exclude a diagnosis of 'cough', 'acute bronchitis' and 'tracheitis'. Its presence allows strong and reliable exclusion of the diagnoses 'gastroenteritis', 'no disease' and 'health  promotion/prevention', and less strong exclusion of 'adverse effects of medication'. The RfE 'sadness' is a strong, reliable predictor for the diagnoses 'feeling sad/depressed' and 'depressive disorder'. It is a less strong, but reliable predictor of a diagnosis of 'acute stress reaction'.  The absence of sadness (as a symptom) is a weak but reliable predictor to exclude the symptom diagnosis 'feeling sad/depressed'. Its presence does not support the exclusion of any diagnosis.
  
  
  CONCLUSIONS
  We describe clinically and statistically significant diagnostic associations  observed between the RfEs 'cough' and 'sadness', presenting as a new problem in family practice, and all the episode titles in ICPC.
authors: Faculty of Life and Health Sciences, University of Ulster, Coleraine, UK. info@thefamilypractice.com.mt
authors: Jean K
authors: JK
authors: Soler
authors: Inge
authors: I
authors: Okkes
authors: Sibo
authors: S
authors: Oskam
authors: Kees
authors: K
authors: Van Boven
authors: Predrag
authors: P
authors: Zivotic
authors: Milan
authors: M
authors: Jevtic
authors: Frank
authors: F
authors: Dobbs
authors: Henk
authors: H
authors: Lamberts
mesh_terms: D001499:Bayes Theorem; D003371:Cough / Q000175:diagnosis* / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D057286:Electronic Health Records / Q000706:statistics & numerical data; D017050:Episode of Care; D005060:Europe / Q000453:epidemiology; D005194:Family Practice / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016013:Likelihood Functions; D015995:Prevalence