The Consultation: A Multi-purpose Framework

  • John G. R. Howie


It is difficult to trace the exact origins of the contemporary interest in clinical decision-making. It is now more than a decade since a group of Glasgow physicians (Taylor et al., 1971) analysed how their colleagues used clinical and laboratory information to diagnose and manage thyroid illness. At about the same time, a multi-disciplinary team developed a mathematical model which revolutionised the accuracy of pre-operative differentiation between adrenal hyperplasia and Conn’s syndrome (Aitchison et al., 1971). The rapid development of computer technology was used to experiment in many other fields, the work of de Dombal (1971 a & b) in the field of management of abdominal pain reflecting the potential, the interest and the difficulties of the field. In 1967, Feinstein produced his classic monograph on ‘Clinical Judgement’ which drew attention to some of the differences between the way doctors are taught to practise medicine and actually carry out their clinical work.


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© John G.R. Howie 1985

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  • John G. R. Howie

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