Diagnosis of colorectal cancer in primary care: the evidence base for guidelines
Family PracticePublished 1 February 2004
William Hamilton
Citations109
SJR quartileQ1
SJR score1.04
SNIP1.06
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TL;DR
Two areas in the Referral Guidelines are questioned: the need to defer investigation of change in bowel habit towards increased looseness or increased stool frequency for 6 weeks, and the low risk nature of constipation.
Abstract
The Referral Guidelines have a reasonable evidence base.
Keywords
Medicine
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