referral appropriateness, whereas some tools used outside the consultation produced more encouraging findings. 1,2would have liked to see a more explicit distinction between consultation-interrupting diagnostic aids and post-consultation tools for case-finding, follow-up, and safety-netting.To my mind, these are not operationally equivalent interventions, and grouping them together risks blurring where implementation effort should now be focused.The practical question is not only why these systems are not used, but also which systems should be prioritised first.My understanding of the evidence discussed is that the better starting point may be tools that strengthen tracking and safety-netting around the consultation, rather than those that compete with the clinician's diagnostic reasoning within it.
Simpson et al. (Thu,) studied this question.