10 Jun 08

Quick diagnosis and treatment of mini-strokes can reduce further stroke risk

A research team led by Oxford University has won major funding to improve diagnostic techniques used in GP surgeries and other NHS primary care centres.

The £2m in funding from the National Institute for Health Research will be used to increase diagnostic accuracy and efficiency where patients are first seen and assessed in the NHS. The aim is to identify important problems in the way diagnoses are made in primary care, improve the use of existing techniques, and develop new technologies.

Research in primary care diagnosis is important to the NHS for two reasons: missed diagnoses cause substantial and unnecessary morbidity, mortality and costs; and inappropriate or unnecessary diagnostic investigations waste resources.

Missed diagnoses in primary care are both common and clinically important. Oxford research has shown that rapid assessment and treatment of transient ischaemic attacks (often called mini-strokes) in primary care is uncommon but has the potential to reduce stroke risk by more than 80%. Similarly, the primary determinant of both the outcome and NHS cost of cancer is the initial diagnosis stage in primary care.

The team includes research groups with complementary expertise in diagnostic technology from the Departments of Primary Health Care, Engineering Science, and Health Economics at Oxford University, together with the Department of Primary Care and General Practice at Birmingham University. It is anticipated that this expert group will be a reference point and source of advice for diagnostic methods and new technological innovation.

‘We have a long track-record of conducting diagnostic research in primary care, trying to provide evidence to help GPs and other front-line clinicians to make better diagnostic decisions,’ says Dr Carl Heneghan of the Department of Primary Care at Oxford University. ‘For example, our recent study of meningococcal disease in children showed that half the cases were missed at first presentation in primary care, often leading to severe disability or death. However, the same study showed how better application of existing diagnostic tools and simple adaptation of new technology for use in primary care might change this situation.’