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Biomedical subjects

J H Barber

Publications and source records attributed to J H Barber.

64 records · Page 4Linked to original sources

The diagnosis of pregnancy in general practice.

In 1,631 pregnancies presenting to general practitioners, the reliability of three proprietary slide tests for the diagnosis of pregnancy was assessed both against the outcome and against the results of hospital tests done at the same time. When all patients were considered the reliability of such tests done in the surgery was 85 per cent against a 90 per cent for hospital tests and when only patients who were more than 42 days pregnant were included, the accuracy figure rose to 87 per cent in general practice and 91 per cent in hospital.The time delay before the results of the hospital test was assessed showed a mean of three days which is considered unacceptable if there are urgent clinical reasons for the test being done. The doctors participating listed their reasons for doing tests and in 54 per cent of cases urgent confirmation or otherwise of the pregnancy was considered essential by either doctor or patient. In the remaining 46 per cent this confirmation was considered simply helpful rather than essential. The study showed that the accuracy of the test, when delegated to a nurse, was acceptable and that in a proportion of three to one the participating doctors considered that the test was of value and worthwhile in patient care.

False Negative Reactions↗

Health centre x-ray unit.

An analysis of the types and numbers of x-ray films requested in the first year of a health centre x-ray unit showed that chest films represented the largest proportion of these. The unit is most valuable when it is inmediately available to the patient and general practitioner at the time of consultation, and thus it should be open for at least five sessions per week. The likely referral rate for the health centre x-ray unit is 84 patients per 1,000 at risk, and a unit functioning for five sessions a week can examine 60 patients during that time. This minimum of five sessions would be fully used by a population of 30,000 patients. The running costs were found to be about the same as those of a hospital x-ray unit.

Community Health Services↗

General-practitioner ward in a district general hospital.

A general-practitioner ward, made available at the local hospital, was used by 34 of 64 local practitioners offered contracts by the regional board. Four of the five doctors in our practice took up contracts, and we were responsible for 119 admissions (100 patients) in one year. Had the general-practitioner ward not been available 73 hospital admissions would have been needed; in 27 cases care at home would have been the alternative, while the remaining 19 patients could have been seen as outpatients. Only seven consultant opinions were sought during the year.

Adolescent↗