No, if the patient clinically has ra +\- raised inflammatory markers the rf doesn't change management
Lesley
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On 4 Nov 2010, at 20:15, Mary Hawking <[log in to unmask]> wrote:
> Does the absence of a positive Rheumatoid factor change the management?
> Suppose a patient presents as a typical - or possible - RhA with high
> inflammatory indices.
> How would your management be changed by either a positive or a negative RA
> latex test?
> And how will the juniors in the Rheumatology Clinic react?
>
> Mary Hawking
>
> -----Original Message-----
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Julian Bradley
> Sent: 04 November 2010 14:47
> To: [log in to unmask]
> Subject: Re: Withdrawal of C-ANCA testing
>
> At 17:51 03/11/2010, you wrote:
>> I'd approach it obliquely.
>>
>> Persuade the lab to append to each result "This test is almost always
>> completely useless in management", and ideally "as it is in this
>> case".
>>
>> Let the GPs and their staff reading that and reading that out to
>> patients cause the information to spread into the oral tradition
>> locally.
>>
>> Put up on your blog or web page and that of the trust a statement on
>> its own on a short page with suitable links to other investigations
>> and to diagnoses, a similar statement, with a single link to your
>> longer argument, that having links to the papers etc.
>>
>> Then wait.
>>
>> If that is difficult to do, or widely regarded as incorrect, then
>> taking forceful action to stop it is less likely to be correct.
>>
>>
>> Some GPs are, presumably, MRCP and Rheumatology GPSIs. It is a
>> mistake to argue that a current occupational category or post
>> precludes the possession of knowledge of a particular sort.
>>
>>
>> Adrian Midgley=A0=A0 http://www.defoam.net/
>
> Adrian,
>
> Thanks. This is almost exactly the line we have taken. In fact ENT
> have an interest as well.
>
> We'll see what the outcome is.
>
> Julian
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