{"id":31350,"date":"2014-04-08T12:01:55","date_gmt":"2014-04-08T11:01:55","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=31350"},"modified":"2014-04-08T12:02:30","modified_gmt":"2014-04-08T11:02:30","slug":"the-bmj-today-if-you-hear-hoof-beats-in-texas-think-of-horses-not-zebras","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2014\/04\/08\/the-bmj-today-if-you-hear-hoof-beats-in-texas-think-of-horses-not-zebras\/","title":{"rendered":"The BMJ Today: If you hear hoof beats in Texas think of horses, not zebras"},"content":{"rendered":"<p>As Saurabh Jha <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g2625\" target=\"_blank\">writes<\/a>, \u201cThe likelihood that someone with cerebral aneurysm hit by a bat develops subarachnoid hemorrhage (near certainty) is not the same as the likelihood that someone who develops subarachnoid hemorrhage after high impact trauma has an aneurysm, hitherto undisclosed (very low).\u201d But would you order tests so you could absolutely rule it out? Would you perhaps order further tests to rule out bleeding brain metastases from lung cancer? Jha asks us to stop \u201chunting for zebras in Texas\u201d and put an end the &#8220;rule-out&#8221; culture that pervades medicine.<!--more--><\/p>\n<p>A dermatology clinic nurse asked a patient with HIV how she became infected. The patient had no idea her HIV status would be disclosed in her GP\u2019s referral letter, and felt stigmatised by the nurse\u2019s question. This incident, described at a National AIDS Trust event, prompts GP Kate Adams to <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g2419\" target=\"_blank\">examine the public interest justification<\/a> in General Medical Council guidance on patient confidentiality. Are doctors sharing too much sensitive information about patients, she asks. And more importantly, are patients being made aware that their data will ordinarily be shared for clinical purposes?<\/p>\n<p>Obsessive-compulsive disorder is in the WHO\u2019s list of the top 10 most handicapping conditions by lost income and decreased quality of life, and it\u2019s the fourth most common mental disorder. Research shows that people can spend 10 years or more struggling with OCD before they get the appropriate help. Veale and Roberts\u2019s <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g2183\" target=\"_blank\">clinical review<\/a> summarises the evidence on how to recognise, assess, and manage people with OCD.<\/p>\n<p>Our new weekly column by the Glasgow GP Margaret McCartney had <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g2447\" target=\"_blank\">a great start<\/a>. Her criticisms of UK tabloid <em>The Sun<\/em>&#8216;s attempts to rehabilitate Page 3 with a breast cancer awareness campaign went viral on Twitter and hundreds of news outlets, including <em>The Sun<\/em>, reported her stance. Now she&#8217;s turned her attention to the bureaucracy that she says has <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g2519\" target=\"_blank\">taken the joy out of medicine<\/a>.<\/p>\n<p><em><strong>Jett Aislabie<\/strong> is an assistant editor on bmj.com.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>As Saurabh Jha writes, \u201cThe likelihood that someone with cerebral aneurysm hit by a bat develops subarachnoid hemorrhage (near certainty) is not the same as the likelihood that someone who [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/04\/08\/the-bmj-today-if-you-hear-hoof-beats-in-texas-think-of-horses-not-zebras\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[447,5750,1357],"tags":[],"class_list":["post-31350","post","type-post","status-publish","format-standard","hentry","category-india","category-the-bmj-today","category-us-health-care"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - 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