Current situation and optimization of follow-up plans for undifferentiated diseases in general practice from the perspective of safety netting

An efficacious approach to the management of clinical uncertainty and the mitigation of the risk of diagnostic oversights are the utilization of safety net recommendations (i.e. conveying structured information to patients about when and where to consult healthcare again). The safety net has been established as the optimal approach for addressing diagnostic uncertainty in the context of international primary healthcare. General undifferentiated diseases are a paradigmatic example of clinical problems with diagnostic uncertainty in China. The extent to which the development of follow-up plans conforms to the basic principles of handling diagnostic uncertainty is unclear at present. The present article introduces and draws upon the definition and content of a safety net, and searches relevant literature on platforms such as CNKI, Wanfang, VIP and Baidu Scholar to analyze the current status of existing follow-up plans for undifferentiated diseases. A comparative analysis is conducted from four perspectives: communication between doctors and patients regarding diagnostic uncertainty, monitoring of warning symptoms, scheduling of follow-up time, and written confirmation of follow-up plans. The results demonstrate that, of the 28 articles included in the analysis, a mere 10 have made specific provisions for follow-up on the risk of a missed diagnosis after diagnosis, The content of these articles is found to be inadequate, indicating a deficiency in grasping the significance of risk management in the context of diagnostic uncertainty. On this basis, and with reference to the fundamental principles of safety net strategies, suggestions for the optimization of follow-up plans were proposed, with the aim of combining the differences in clinical characteristics between undifferentiated diseases and traditional diseases. The specific discussions were conducted from four perspective: differences in clinical thinking, differences in the types of symptoms experienced during follow-up, the development of personalized follow-up plans, and the maintenance of written records. This indicates that the pursuit of clear diagnoses through excessive examination is not the only paradigm for combating disease risks caused by uncertain diagnoses. The implementation of a series of risk management plans, is a strategy that has been demonstrated to facilitate the realization of this objective, while concurrently ensuring optimal feasibility and economic efficiency.