title: The time-efficiency principle: time as the key diagnostic strategy in primary care.
abstract: The test and retest opportunity afforded by reviewing a patient over time substantially increases the total gain in certainty when making a diagnosis in low-prevalence settings (the time-efficiency principle). This approach safely and efficiently reduces the number of patients who need to be formally tested in order to make a correct diagnosis for a person. Time, in terms of observed disease trajectory, provides a vital mechanism for achieving this task. It remains the best strategy for delivering near-optimal diagnoses in low-prevalence settings and should be used to its full advantage.
authors.affiliation: Department of Primary Care, University of Liverpool, Liverpool, UK. greg.irving@liv.ac.uk
authors.forename: Greg
authors.initials: G
authors.lastname: Irving
authors.forename: John
authors.initials: J
authors.lastname: Holden
mesh_terms: D003266:Continuity of Patient Care / Q000592:standards; D003954:Diagnostic Services / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D061214:Patient Safety; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods / Q000458:organization & administration; D011787:Quality of Health Care; D063189:Symptom Assessment / Q000379:methods / Q000706:statistics & numerical data; D017748:Time Management / Q000458:organization & administration*
keywords: Continuity of care; diagnostic tests; patient safety; primary care; quality of care.
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