Emerging diagnostic technologies in primary care: what’s on the horizon?

Abstract

Apart from computers sitting in consulting rooms, most GPs’ desks and doctor’s bags include an array of fairly old-fashioned medical equipment such as stethoscopes, auroscopes, and peak flow meters. For instance, the Wright Peak Flow meter was first introduced in the 1970s, and it seems many of the technological advances of the 21st century have largely bypassed diagnostic testing in general practice. GPs are often reminded of this after patients have been referred to hospital, where within a very short period of time, they receive numerous blood tests, imaging investigations, and rapid pathology. But GPs do have good access to almost all of the same blood tests that are available to hospital settings, indeed the numbers of blood tests performed in general practice has increased dramatically in recent years. Much of this increase is driven by guidelines to screen more patients and monitor them more frequently,1 and additional factors include diagnostic uncertainty, patient anxiety, and litigation, among others. This is not to downplay the key role that history and examination plays in directing further clinical assessment, but many symptoms and signs are insufficient to rule in or rule out particular diagnoses, or to monitor patients with chronic diseases. Technological advances in diagnostic tests that are found in hospitals are now poised to appear in primary care. Many of these advances have occurred because of the speed, size and range of devices that can provide accurate measurements of a wide range of biochemical, …