Thread by @drjessicawatson

1/6 What is the usefulness of inflammatory markers such as CRP, ESR and PV in #primarycare? My #PhD findings may make you think carefully about doing these tests. A thread 👇bjgp.org/content/early/…

2/6 Inflammatory markers have an overall sensitivity of <50% so are not a useful 'rule out' test:

3/3 1000 inflammatory marker tests generates:
236 false-positives ...resulting in an additional
710 GP appointments
229 phlebotomy appointments
and 24 referrals
....in the following 6 months

4/6 Testing multiple inflammatory markers simultaneously does not increase ability to rule out relevant disease.
CRP has marginally superior diagnostic accuracy so should generally be 1st line
bjgp.org/content/early/…

5/6 Interpretation depends on the clinical reason for testing. Incidence of relevant disease increases with rising test results:

6/6 Consider cancer in men>50 and women >60 with unexplained raised inflammatory markers BUT don't rely on inflammatory markers to 'rule out' cancer nature.com/articles/s4141…

***Links to inflammatory marker papers here:
bjgp.org/content/early/…
bjgp.org/content/early/…
nature.com/articles/s4141…
Thank you so much for the comments and feedback!