Several mothers, Ms. Leitao said, told her that they had lost custody of their children after doctors decided the youngsters' symptoms were contrived.
However, if treatment (for example, 'antidepressant' medication) results in an improvement in select symptoms, the clinician should use her or his best judgment to decide whether the symptoms would have persisted or progressed if treatment had not been initiated.
Consequently, for every patient that seeks advice, it is the physician who has to decide whether the symptoms are irrelevant or circumstantial (and, by extension, not constitutive of disease), or alternatively, whether the patient is really suffering from GERD.
This is so in the two principal clinical situations provoked by patients with typical GERD symptoms, namely, the need to decide whether the symptoms are constitutive of disease (GERD diagnosis); and the persistence of symptoms with treatment (adequate or inadequate response).
It is therefore debatable as to whether the patient or the professional should decide when the symptoms become refractory and whether all palliative treatments need to have been "applied" or just "offered"." To be sure, the EAPC framework recognises the "subjectivity of refractoriness" (p. 582) [ 4].
We think these patients will seldom screen positive using self-report measures of somatoform disorders or symptoms, since they need a thorough investigation involving their doctors in order to decide the nature of symptoms.
Interviewers continue to probe until there is enough information to decide whether the symptom is present at pre-specified levels of severity.
The interview serves as a guide in determining whether a symptom is present at prespecified levels and the interviewer is expected to probe until she or he can decide whether the symptom is present.
Only one of the four hits Newton took to the head was flagged by the independent concussion spotting team for review, but after reviewing the video they decided his symptoms on the video didn't merit further investigation.
Because many of the responses referred to trauma-related symptoms, we decided that trauma symptoms would be the primary study outcomes, and dysfunction would be the secondary study outcome.
