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The 'referral visit' step was the main contributor to the second axis, 'same as first consultation' and 'other specialist' to 'regular source of care' and 'self-referral'.
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Four patients were diagnosed at first consultation.
Zomba district hospital, with over 500 beds is the largest health facility in the district and serves both as the first consultation point for patients within its catchment, and as a referral centre for other 23 primary health centres.
It is possible that some family physicians incorrectly recorded a subsequent consultation as the first consultation for dizziness.
Each AT session lasted on average 40-45 min in duration, although the first lesson lasted longer as a first consultation.
19 The index consultation (and hence the index doctor) was defined as the first consultation in the 12 months before diagnosis when a relevant cancer symptom or sign was recorded by a GP.
Patients were also required to have at least 24 months of recorded data before, and 18 months after, their index date (defined as their first consultation for gout between January 2000 and June 2005).
According to international coding standards for cancer registries [ 14], the date of incidence was defined as the first consultation at a hospital for the cancer in question or later diagnostic confirmation (e.g. diagnosis by a physician, pathology, date of death).
The time of the first consultation was marked as 'the, timetime of retest as 'T1'.
Another explanation might be that according to Livingston and colleagues, physicians may be uncomfortable referring patients at a time when patients are overloaded with information (e.g. treatment, and side-effects) [ 34], as is the case during a first consultation.
This second consultation on PIP was only undertaken to head off a judicial review as the DWP's first consultation had failed to mention its intention to change the qualifying criteria for higher rate mobility payments.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com