Second opinions and tertiary referrals in neurology

Wijers, D. J. B.; Richard, Edo; Vergouwen, Mervyn D.I.; Stam, J

doi:10.1007/s00415-008-0019-3

Cited by 16 publications

(15 citation statements)

References 20 publications

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“…And, this technology is found most of the time only in extensively populated cities, especially in areas of the world with limited resource investment in health care, such as Latin America -LA [13]. On the other hand, limited knowledge about neurological diseases exhibited by general practitioners usually leads to high numbers of second opinions and referral to tertiary facilities of patients suffering these conditions [14]. Finally, countries like the United Kingdom -UK or Colombia are claiming physicians' scarcity [15,16].…”

Section: Introductionmentioning

confidence: 98%

Different neurological conditions between urban and rural samples from central Colombia

Habeych

García-Habeych

Castilla-Puentes

2012

Journal of the Neurological Sciences

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Section: Introductionmentioning

confidence: 98%

Different neurological conditions between urban and rural samples from central Colombia

Habeych

García-Habeych

Castilla-Puentes

2012

Journal of the Neurological Sciences

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“…A new treatment advice was given in 50% of the patients who had been referred to a general neurology out-patient clinic of a university hospital [2]. In a retrospective study by the University of Zürich, in more than 60% of the patients referred to a university vertigo centre a new diagnosis was made, while for 70% of the patients who had been referred to this centre no diagnosis had been made before the referral [6].…”

Section: Discussionmentioning

confidence: 99%

“…Around 800 of them are patients who come for a second opinion or tertiary referral. We define a second opinion as a consultation that is initiated at the explicit request of the patient, while a tertiary referral is a consultation that has been requested by a doctor because of insufficient expertise or uncertainty about the diagnosis or treatment [2]. …”

Section: Introductionmentioning

confidence: 99%

Referrals to a Specialised Dizziness Clinic often Result in Revised Diagnoses and New Therapeutic Advice

Leeuwen

Zaag-Loonen²

2014

Eur Neurol

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Background: Patients with dizziness are frequently referred to specialised centres for a second opinion. The incremental diagnostic and therapeutic yield of this approach has rarely been studied. Aim of the Study: How often is a new diagnosis or treatment advice given to patients with dizziness who are referred for a second opinion to a tertiary multi-disciplinary expertise centre? Methods: In a prospective observational study, the following data were collected: reason for referral, diagnosis and treatment made by ENT surgeon and a neurologist in consensus. Results: In the complete group of patients (n = 327), a new (or amended) diagnosis was made in 54% and 62% of the patients received a new treatment advice. Conclusion: Referral of selected dizzy patients to a multidisciplinary centre provides a revised diagnosis or treatment recommendation for a majority of patients. i 2014 S. Karger AG, Basel

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“…In a recent qualitative study (March 2017), 23 patients with localized or advanced prostate cancer (that sought sec-was related to the amount of information and emotional support provided by the neurologist during the day-care admission [45,47,[70][71][72][73]. Another finding is that the psychological relevance of second opinion led to a short-term increase in patient satisfaction, but, after two years, satisfaction had decreased to the level seen prior to the second opinion; the benefit of second opinion consultations seems to be reasonable in the short term, but limited in the long term [74].…”

Section: Economic Impact Of the "Second Opinion Medical Network"mentioning

confidence: 99%

The “Second Opinion Medical Network”

Palmieri¹

2017

Int J Pathol Clin Res

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The "Second Opinion Medical Network" is a consultation referral web and medical office system recruiting a wide panel of real-time available specialists, to whom any patient affected by any disease or syndrome and not satisfied with the diagnosis or therapy can apply for an individual clinical audit. Due to the physician-patient communication gap, most of the patients usually wander around the medical websites looking for proper answers to their health problems. However, this search often becomes compulsive and obsessive and frequently ambiguous and frustrating. Palmieri, et al. defines this borderline or even pathological behavior as the "Web Babel Syndrome"-psychological imbalance affecting young and elderly patients, often with multiple synchronous diseases receiving by their care givers heterogeneous and misleading informations or advices, as well as, confused, contradictory statements and prescriptions. To deal with this problem, the "Second Opinion Medical Network" aims to be a useful "problem-solving" support revisiting each conflictual diagnostic and therapeutic step and properly re-addressing tailored treatments and prognoses, preventing unnecessary investigations and unhelpful and expensive medical and surgical interventions.The aim of this editorial is to describe the role and benefits of such a medical network in our web connected health care system. KeywordsSecond opinion, Network, Surgery, Cancer, EconomyIn 2002, a survey of 4,530 people in Europe and USA showed that 32% of Europeans and 43% of Americans preferred to use health web sites, sponsored by BBC and Yahoo, for health information [3]. However, the internet sites are often lacking of adequate information concerning disease complications and aftercare [4]. This web-searching behaviour is often continuous, compulsory, somehow obsessive, leading to the "Web Babel Syndrome", defined as a physician-patient communication gap frequently occurring when the patient affected by multiple synchronous pathologies, feeds back heterogeneous and misleading informations and prescriptions with the risk to drop in a confusionary state [5][6][7][8].In 1999, the Institute of Medicine report cited fatal medical errors in some 40,000-98,000 Americans PER year [8] supporting once more the concept that a further consultation or specialistic second opinion may be useful antidote to lethal misdiagnosis [9].The term "second opinion" has been widely reported also in histology [10,11] and pathology (e.g. thyroid pathology) [12][13][14][15][16][17][18][19][20] where the diagnosis is often difficult, misunderstood and strongly based on the healthcare professionals' experience. It has been defined as a qualified, interdisciplinary medical opinion, based on medical evidence, of an experienced medical specialist or a team [21]. An effective and helpful second opinion strategy in various pathologies (e.g. oral pathology) is the use of smartphones and software applications, such as WhatsApp Messenger, a crossplatform mobile messaging application that allows the exchang...

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Second opinions and tertiary referrals in neurology

Abstract: A high number of second opinion and tertiary referral patients benefits from a day-care admission in a neurological outpatient clinic. Careful selection for referral of patients who will benefit from daycare admission may even enlarge the diagnostic and therapeutic yield.

Cited by 16 publications

References 20 publications

Different neurological conditions between urban and rural samples from central Colombia

Different neurological conditions between urban and rural samples from central Colombia

Referrals to a Specialised Dizziness Clinic often Result in Revised Diagnoses and New Therapeutic Advice

The “Second Opinion Medical Network”

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