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Biomedical subjects

M J Sladden

Publications and source records attributed to M J Sladden.

27 records · Page 2Linked to original sources
PubMed1999

Rectal bleeding in general practice patients.

OBJECTIVE: To determine the prevalence of observed rectal bleeding in general practice patients, the health seeking behaviour of those with rectal bleeding, and what rectal bleeding 'means' to patients in terms of perceived health risk. METHOD: Self administered questionnaire survey of general practice patients aged 50 years and over in northern Tasmania recruited as they visited their general practitioner (GP). RESULTS: The reported lifetime prevalence of rectal bleeding in our sample was 33% (299 of 903 respondents). It was more common in younger people, becoming less common with increasing age. Many respondents do not examine for bleeding. Only 45% of respondents with rectal bleeding consulted their GP about the most recent bleed. Patients were more likely to consult if they reported blood in the toilet pan and if they sought advice from a family member. There were significant differences between the meaning of bleeding for GP consulters and non consulters. This may have important implications for health education. CONCLUSION: Colorectal cancer (CRC) is a common problem managed by a combination of screening and case finding. With the high prevalence of rectal bleeding and low consultation rates for this problem there is potential to enhance the effectiveness of early detection of CRC through general practice based public health and education campaigns.

Adult↗
PubMed1995

General practitioners' attitudes to screening for prostate and testicular cancers.

OBJECTIVE: To assess general practitioners' (GPs') perceptions of the effectiveness of screening for prostate and testicular cancers, and their self-reported levels of screening for these conditions in the light of the conflicting advice available to GPs, and a lack of evidence to support testing for either of these cancers. DESIGN: A questionnaire sent to all 101 GPs in the Division of General Practice, southern Tasmania. RESULTS: There was an 82% response rate to the questionnaire. GPs had an accurate knowledge of the epidemiology of these cancers. Of 57 GPs who thought that digital rectal examination was an effective screening test for prostate cancer, 56 said they should screen asymptomatic patients but only 37 said they actually did screen. The corresponding results for prostate-specific antigen screening were 45, 26 and 13, respectively. For testicular cancer screening, 59 GPs thought that clinical examination of the testes was an effective screening test, 55 said they should screen asymptomatic patients but only 21 said they actually did screen. Corresponding results for testicular self-examination were 56, 57 and 21, respectively. CONCLUSIONS: Many GPs are uncertain about the tests available for screening for prostate and testicular cancers. Some think they should screen, but few do so consistently. Clear and precise evidence-based guidelines for screening for these conditions are necessary.

Adult↗
PubMed1989

How many GP referrals to dermatology outpatients are really necessary?

In a survey of patients referred to the dermatology outpatients department of a British teaching hospital, 26% of referrals were considered unnecessary by a senior house officer with three months practical dermatological experience. We conclude that better undergraduate and postgraduate education in dermatology is essential. A period spent in dermatology should be included in all vocational training schemes for general practice.

Ambulatory Care↗
PubMedDate not supplied

How do general practitioners manage rectal bleeding?

OBJECTIVE: To determine how general practitioners (GPs) in northern Tasmania manage rectal bleeding in terms of examination, referral, and patient investigation and estimate the value of early diagnosis of colorectal cancer (CRC). METHOD: Self reported postal questionnaire survey sent to 100 randomly selected GPs in northern Tasmania. RESULTS: Sixty-eight per cent of GPs responded. The clinical action proposed by GPs varied considerably according to patient age and type of rectal bleeding. The proportion of GPs who would refer a patient to a specialist varied from 15 to 100% depending on the specific scenario. Responses were not consistent with the available consensus guidelines and evidence. Most GPs believed that early diagnosis of CRC through screening and the early detection of rectal bleeding improved outcomes. However, fewer than half the respondents believed that there were clear guidelines about the management of a patient with rectal bleeding, emphasising the need for evidence-based guidelines which are effectively disseminated and clinically evaluated. Rural GPs indicated that distance from specialist investigation and referral centres would influence patient management. CONCLUSIONS: There is a wide variation in the way GPs manage rectal bleeding and inconsistent knowledge about the existence of guidelines for managing rectal bleeding. Evidence-based education about the management of this common clinical problem, which is effectively disseminated and clinically evaluated, would seem appropriate.

Adult↗