The edition · Family Medicine
Alcohol biomarker and questionnaire flagged different patients in Swedish primary care
A Swedish record study of phosphatidylethanol against AUDIT and reported drinks, a synthesis of what GPs find hard about urinary infections, and two small primary care studies on walking speed and pre-visit history-taking.
The edition in brief
A retrospective Swedish primary care study linked health records and registries to compare the alcohol biomarker phosphatidylethanol (PEth) with the AUDIT questionnaire and reported weekly drinks. Hazardous use was flagged in 26.5% by AUDIT of 8 or more, 14.6% to 18.3% by PEth above 210 ng/mL, and 8.5% by reporting 10 or more drinks a week. Each method found patients the others missed, and PEth correlated only moderately with self-report. The authors advise reading PEth alongside self-report and not as a stand-alone test. A qualitative evidence synthesis of 32 studies of 677 primary care practitioners found confidence in managing urinary tract infections that gave way to uncertainty with children, men, older patients and recurrent infection. A feasibility study of 30 people in a UK diabetes clinic found a timed 28-metre corridor walk the most practical way to measure walking speed. A randomised pilot of 43 patients found pre-visit computer-assisted history-taking with a copy-ready summary raised documentation completeness from a median 46.9% to 100%, with no clinical outcomes measured.
Why GPs hesitate over urinary infections: children, men, older patients and recurrence
Build a clear pathway for the patient groups where UTI management feels uncertain, including when to send urine for culture.
A timed corridor walk was the most practical way to measure walking speed in a diabetes clinic
A timed corridor walk is a practical way to start recording walking speed in a diabetes clinic, but there is no treatment rule attached to it yet.
Pre-visit digital history-taking made screening notes complete in a small randomised pilot
Pre-visit questionnaires may help structure notes in a short consultation, but there is no evidence yet that they change diagnosis or outcome.
Send a urine culture before antibiotics in the groups where UTI is not straightforward
Take a urine culture before antibiotics whenever the UTI is not a straightforward one.
PEth and AUDIT flagged different patients, so use them together
Do not rely on a single measure of alcohol use: combine questionnaire, drinks history and, where available, PEth.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this one is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for family medicine, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free