The British journal of general practice : the journal of the Royal College of General Practitioners
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Medical science stands accused of providing an incomplete understanding of health because it is supposedly founded on linearity, reductionism, and positivism. These criticisms misrepresent the scientific method. The alternatives offered by complexity theory, postmodernism, and qualitative research risk falling into the traps that the scientific method avoids. The hypotheticodeductive model of science provides both a coherent description of the growth of scientific knowledge and a prescription for the conduct of good science.
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We report an analysis of the qualitative phase of a study of patients' and carers' views of primary care services, focusing on their experiences of access to face-to-face general practitioner (GP) consultations during the period when new access policies were being implemented. Practices interpreted the new policy in various ways; restricted interpretations, including restriction of access to telephone booking, could cause distress to patients. Patients and carers welcomed flexible interpretations of the policy that offered choice, such as a choice of GP, or of booking in advance.
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In December 2000, the Committee for Safety of Medicines (CSM) advised that thioridazine may prolong QT intervals risking arrhythmias. We investigated the impact on general practitioner prescribing of thioridazine using a time series analysis. ⋯ Costs mimicked these changes. Fresh criteria are proposed for appraising the quality of evidence needed to inform future urgent facsimile transmissions.
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For the early detection of gynaecological malignancy, guidance based on presenting symptoms exists to aid a general practitioner (GP) in determining who to investigate or refer. The evidence for this advice is based on the prevalence of symptoms in women with gynaecological malignancy or within specialist clinics. There are no studies on the incidence of symptoms within the community. ⋯ The development of symptoms of menstrual loss among women in the community is common, in contrast to the rarity of gynaecological malignancy. This raises concern about the usefulness of current guidelines, based on symptoms, advising women when to consult, and for the early detection of gynaecological malignancy in the community and primary care.