Clin Med
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Iron-deficiency anaemia (IDA) is often inappropriately investigated. This study aimed to improve referrals, estimate cost implications and determine effectiveness of referral criteria for diagnosing cancer. Patients referred for investigation of anaemia were studied. ⋯ Fourteen of 112 patients with IDA had cancer versus 4/109 non-IDA (p < 0.025), overall prevalence 8.1%. Many referrals for anaemia investigation are inappropriate and a 35% reduction was achieved. The sensitivity and negative predictive value of the referral criteria for diagnosing gastrointestinal cancer were 77.8% and 96.3% respectively.
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Hypertrophic cardiomyopalthy can occur at any age, not just in younger patients. An electrocardiogram showing voltage criteria for left ventricular hypertrophy with prominent ST changes and deep T wave inversion should alert the clinician to this possibility Echocardiograpghy will make the diagnosis in the majority of patients.