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Table 4 Major themes and subthemes emerging from interviews with 28 GPs

From: Challenges and strategies for general practitioners diagnosing serious infections in older adults: a UK qualitative interview study

Major theme Subthemes
Challenges leading to diagnostic uncertainty Patient complexity Multi-morbidity, polypharmacy, social needs
Atypical presentation Non-specific symptoms and signs
Knowledge of patient GP workload, continuity of patient care
Approaches to recognising the suspected serious infection in older adults History taking Recognition of non-specific symptoms including confusion, falls, incontinence, unsteadiness, lethargy and vomiting Change from baseline Collateral history from relatives and carers, reviewing notes
Physical examination Standardised systematic approach including temperature, respiratory rate, pulse, blood pressure and oxygen saturation Exam findings often not considered trustworthy, role of gut feeling
Scoring systems Judge disease severity, communication to secondary care
Strategies to manage diagnostic uncertainty Investigations Varied levels of trust in different tests, ease of access
Safety netting Safety net through third party, shared decision making