Over and above, none of the studies mentioned blinding to the outcome assessors, which promotes suspicion of detection bias.
Nevertheless, the participants' perception of morbidity may have changed between the time of suspicion or detection and the referral visit (when it is measured), depending on the nature of their experiences along the healthcare pathway.
Sicca symptoms are nonspecific and may be seen in several medical conditions or as the result of medications or aging, and SS can often present with relatively nonspecific symptoms, thus requiring a high level of suspicion for detection.
a) seriousness; b) urgency: patients and parents were independently asked to indicate on four-point scales their perception, at the time of scoliosis suspicion or detection, of the seriousness of the back problem and of the urgency of consulting a physician.
A healthcare pathway is defined as the patient's journey through the primary healthcare system from scoliosis suspicion or detection to the referral consultation, including all encounters with medical doctors, allied health professionals or alternative caregivers, for investigation, provisional diagnosis, management, and referral.
For these, the CT imaging technique applied in a significant proportion of patients is a conventional one and radiologists should have a high level of suspicion in the detection and interpretation of bowel wall abnormalities.
In patients with clinical suspicion or endoscopic detection of gastro-duodenal disease, the attending radiologist may opt for a dedicated CT study with gastric distension to assess the true mural thickness and structure.
Carcinoid syndrome is a typical example, and can be characterised by clinically apparent signs that appear late in the disease, when the tumour has already spread to the liver 2. This small index of clinical suspicion makes the detection of small bowel tumours a challenge for all clinicians.
Of the 682 entries of highly pathogenic and low pathogenicity viruses detected in wild birds from the 37 countries reporting detection or suspicion of avian influenza, 244 entries were at the serotype (HA type or subtype combination) level of information.
After ultrasound in case of sustained suspicion, the sensitivity in detection of severe SGA was 25% and positive predictive value (PPV) 16%.
It could be hypothesised that offenders act in the knowledge that information is not well shared between the different enforcement agencies, and move regularly between the above and below settings discussed in this paper, to avoid detection and suspicion.
