Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital

Shuang Xu; Jing Liu; Yun Chen; Qing Zhang

doi:doi:10.11648/j.ajcem.20241204.11

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Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital

Shuang Xu

, Jing Liu

, Yun Chen

, Qing Zhang^*

Published in American Journal of Clinical and Experimental Medicine (Volume 12, Issue 4)

Received: 20 September 2024 Accepted: 26 October 2024 Published: 31 October 2024

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Abstract

Background Patients with medically unspecified disease (MUD) may present at any disease stage, with clinical manifestations and test results that do not lead to a clear diagnosis, posing a common challenge in clinical settings. General practitioners, with their patient-centered approach and holistic medical models, have an advantage in diagnosing and treating MUD. Standardizing the diagnosis and treatment of MUD is a crucial skill for general practitioners. However, there is currently a lack of data on the treatment of MUD in general outpatient clinics of comprehensive tertiary hospitals. Objective This study examines the prevalence of medically unexplained symptoms (MUS) in general outpatient clinics, offering insights for general practitioners in tertiary hospitals on diagnosing and treating MUS. It also serves as a foundation for standardizing the diagnostic and treatment protocols for MUD. Methods Select patients diagnosed with medically unspecified disease (MUD) who visited the outpatient department of our general medicine department between September 2021 and September 2022. Collect basic information and follow-up data for one year post-visit, and analyze the reasons for the initial visit and subsequent follow-up outcomes. Results A total of 576 patients with MUD received treatment at the general outpatient department, with an average age of (44.97 ± 13.50) years. There was no statistically significant difference in the age distribution among male and female MUD patients (P > 0.05). Chest pain was the most common reason for treatment of medically unspecified disease in the general outpatient department. Among patients treated for chest pain, there were more males than females (P < 0.05), and a greater number of patients were treated in specialized clinics compared to general clinics (P < 0.05), The majority of patients remained undiagnosed and had either 0 or no more than 2 visits within a year. There was no significant correlation between anxiety scores and age, although female patients, those with chest pain, healthcare staff, and non-smokers reported higher levels of self-anxiety. Conclusion MUD patients have various reasons for seeking medical treatment. General practitioners in comprehensive tertiary hospitals should make full use of relevant resources, attach importance to the full evaluation of the psychological status of MUD patients, standardize the diagnosis and treatment process of MUD, and provide more comprehensive diagnosis and treatment services.

Published in	American Journal of Clinical and Experimental Medicine (Volume 12, Issue 4)
DOI	10.11648/j.ajcem.20241204.11
Page(s)	45-51
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Medically Unspecified Disease, Comprehensive Tertiary Hospitals, General Practice, Medical Treatment, Anxiety Score

1. Background

The concept of undifferentiated disease (medically unexplained symptoms, MUS) was put forward by doctors Slavney and Teitelbaum in 1985. In China, this kind of disease is named undifferentiated disease (medically unspecified disease, MUD), which refers to the somatic symptoms that can not be explained in medicine

[1]

or a kind of disease which can not be clearly diagnosed according to the current clinical symptoms and related laboratory tests. Patients often go to see a doctor repeatedly with one or more symptoms, physical examination and auxiliary examination are mostly normal or mildly abnormal, which can not be attributed to clear organic diseases, which usually cause long-term trouble to patients. This concept was introduced into China by the Department of General Medicine of the first Hospital of Zhejiang University in 2014. After nearly 10 years of clinical practice and scientific research, it has seen an embryonic form, but it has not yet formed a systematic and standardized process of diagnosis and treatment of MUD

[2]

General practitioners pay attention to people-oriented, health-centered, based on the "bio-psycho-social" medical model, to provide patients with comprehensive, continuous and individual medical services, which makes general practitioners have more advantages in the management of undifferentiated diseases. Based on this, more and more experts propose that the general medicine department of general hospitals should be built into a MUD diagnosis and treatment center, establish and improve a coordinated diagnosis and treatment mechanism, and better provide comprehensive medical security for MUD patients

[3]

. However, at present, there is a lack of research results on the diagnosis and treatment of MUD in the general medicine department of comprehensive third-class hospitals, and the diagnosis and treatment of MUD is still being explored. The purpose of this paper is to provide a reference for the diagnosis and treatment of MUD in general practitioners in comprehensive third-class hospitals, and to provide a basis for standardizing the diagnosis and treatment process of MUD through the analysis of the situation of patients with MUD in the general clinic of comprehensive third-class hospitals.

2. Objects and Methods

2.1. Object of Study

Patients exhibiting symptoms of myocardial infarction with chest tightness, chest pain, abdominal pain, fatigue, and edema were selected between September 2021 and September 2022 at the general medicine clinic of our hospital.

2.2. Research Methods

The study collected data on patient sex, age, diagnosis, and anxiety scores from the outpatient electronic medical record system, and followed up on patients' progress within one year post-treatment through electronic medical records and telephone follow-ups.

2.3. Statistical Methods

Statistical analysis was conducted using SPSS 26.0 software, with measurement data presented as (x±s). Group comparisons were performed using the χ2 test and analysis of variance.

3. Results

3.1. Comparison of the Age Composition of the Number of MUD Patients of Different Genders

A total of 576 MUD patients were included in the study, with 2 cases being excluded due to lack of contact information and follow-up data. Of the remaining patients, 261 were male (45.5%) and 313 were female (54.5%). The age range of the patients was 14 to 81 years, with an average age of 44.97 years (SD = 13.50). Among the patients, 40 were under 25 years old (22 males, 18 females), accounting for 6.97% of the total. Additionally, 202 patients were between 25 and 45 years old (100 males, 102 females), representing 35.19% of the sample. Furthermore, 292 patients were aged 45 to 65 years (124 males, 168 females), making up 50.87% of the cohort. Lastly, 40 patients were 65 years or older (15 males, 25 females), constituting 6.97% of the total. In terms of clinic settings, 90 patients were seen in general outpatient clinics (15.68%), while 484 patients were seen in expert outpatient clinics (84.32%). Statistical analysis revealed no significant difference in the age distribution between male and female MUD patients (P > 0.05) (Table 1).

Table 1. Comparison of the number of visits and age composition of patients with medically unspecified disease by sex.

Gender		The number of patients in each age group (n,%)
Gender	Total number of cases	<25 years old	25~45 years old	45~65 years old	≧65 years old
male	261	22 (8.43)	100 (38.31)	124 (47.51)	15 (5.75)
female	313	18 (5.75)	102 (32.59)	168 (53.67)	25 (7.99)
χ2			4.879
P			0.181

3.2. Top 5 Symptoms and Sequence

In this study, 22 MUD symptoms were collected, with the top 5 symptoms representing 82.6% of all symptoms. The most common symptom leading to undifferentiated disease visits in general practice clinics is chest pain, accounting for 39.7% of all symptoms. This is followed by abdominal pain, chest tightness, fatigue, and dizziness. (Table 2)

Table 2. Top 5 symptoms and sequence of patients.

Order	MUD symptoms	Number of cases(n)	Constituent ratio (%)
1	chest pain	228	39.7
2	abdominal pain	94	16.4
3	chest tightness	71	12.4
4	lack of strength	50	8.7
5	dizzy	31	5.4

3.3. Comparison of Visit and Follow-up of Patients with Different Symptoms

Analysis of the consultation and follow-up status of the top five MUD symptoms revealed several key findings. Firstly, among patients presenting with chest pain, there was a higher proportion of men compared to women (χ2 = 13.348, P < 0.05). Secondly, more patients sought care at specialist clinics rather than general clinics (χ2 = 6.359, P < 0.05). Thirdly, a larger number of patients did not return for follow-up within 1 year or only visited 1-2 times compared to those who visited 3 or more times (χ2 = 8.291, P < 0.05). Additionally, patients with undiagnosed chest pain and chest tightness outnumbered those with confirmed diagnoses (χ2 = 13.744, P < 0.05; χ2 = 6.525, P < 0.05). Notably, there was no significant age-based difference among patients with different symptoms. (Table 3)

Table 3. Comparison of visit and follow-up of patients with different symptoms.

Project	Total numbers	Chest pain	Abdominal pain	Chest tightness	Lack of strength	Dizzy
Gender
male	261	125 (47.89)	38 (14.56)	35 (13.41)	23 (8.81)	12 (4.60)
female	313	103 (32.91)	56 (17.89)	36 (11.50)	27 (8.63)	19 (6.07)
χ2		13.348	1.154	0.478	0.006	0.604
P		0.000	0.283	0.489	0.937	0.437
Age (years)
<25	40	15 (37.50)	7 (17.50)	8 (20.00)	2 (5.00)	3 (7.50)
25~45	202	88 (43.56)	23 (11.39)	31 (15.35)	19 (9.41)	11 (5.45)
45~65	292	113 (38.70)	57 (19.52)	29 (9.93)	27 (9.25)	15 (5.14)
≧65	40	12 (30.00)	7 (17.50)	3 (7.50)	2 (5.00)	2 (5.00)
χ2		3.035	5.855	6.277	1.613	0.398
P		0.386	0.199	0.099	0.656	0.941
Outpatient category
expert	484	203 (41.94)	78 (16.12)	58 (11.98)	38 (7.85)	27 (5.58)
ordinary	90	25 (27.78)	16 (17.78)	13 (14.44)	12 (13.33)	4 (4.44)
χ2		6.359	14.740	0.424	2.868	0.191
P		0.012	0.696	0.515	0.090	0.662
The number of re-isits
0	480	203 (42.29)b	80 (16.67)	55 (11.46)	42 (8.75)	24 (5.00)
1~2	84	23 (27.38)b	11 (13.10)	14 (16.67)	7 (8.33)	6 (7.14)
≧3	10	2 (20.00)a	3 (30.00)	2 (20.00)	1 (10.00)	1 (10.00)
χ2		8.291	2.045	2.336	0.037	1.064
P		0.016	0.360	0.311	0.982	0.587
Definite diagnosis
yes	29	2 (6.90)	7 (24.14)	8 (27.59)	5 (17.24)	3 (10.34)
no	545	226 (41.47)	87 (15.96)	63 (11.56)	45 (8.26)	28 (5.14)
χ2		13.744	1.344	6.525	2.795	1.461
P		0.000	0.246	0.011	0.095	0.227

Note: the difference between a and b is statistically significant (P < 0.05).

3.4. Comparison of Anxiety Scores of Patients with Different Symptoms

Patients with chest pain had significantly higher anxiety scores compared to those with other symptoms (F = 35.196, P < 0.05). No significant statistical difference was found in the anxiety scores of patients with other symptoms. Refer to Table 4 for more details. (Table 4)

Table 4. Comparison of anxiety scores in patients with different symptoms.

Project	Chest pain	Abdominal pain	Chest tightness	Lack of strength	Dizzy
Anxiety score	37.23±9.10a	30.28±5.49b	29.76±4.54b	28.10±2.63b	29.19±3.61b
F	35.196
P	0.000

Note: the difference between a and b is statistically significant (P < 0.05).

3.5. Analysis of Related Factors of Anxiety Score

A positive correlation was found between self-scores of anxiety and gender (correlation coefficient = 0.375, p < 0.01). Additionally, a significant positive correlation was observed between self-rating of anxiety and diagnosis (correlation coefficient = 0.353, p < 0.01), with patients experiencing chest pain reporting higher levels of anxiety. Conversely, a negative correlation was found between self-ratings of anxiety and smoking history (correlation coefficient = -0.331, p < 0.01), suggesting that smokers tend to have lower anxiety levels. Furthermore, a slight but significant positive correlation was identified between self-ratings of anxiety and occupation (correlation coefficient = 0.084, p < 0.05), with employees reporting higher self-scores of anxiety. (Table 5)

Table 5. Analysis of related factors of anxiety score.

Variable	Anxiety score	Gender	Age	Diagnosis	Smoking history	Occupation
Anxiety score	1.000	0.375	0.011	0.353	-0.331	0.084
P	0.000	0.000	0.798	0.000	0.000	0.041

4. Discussion

General practitioners play a crucial role in managing patients with medically unspecified disease (MUD), although a systematic and standardized treatment process has not yet been established in clinical practice

[2]

. It is currently important to focus on developing a MUD clinical pathway guided by 'general practice thinking'. This involves researching and implementing management plans based on the country's MUD management framework and assessment tools, in order to enhance the formulation of undifferentiated disease diagnosis and treatment guidelines or expert consensus in China

[4]

. General medicine, characterized by being 'people-centered and providing sustainable, comprehensive, and individualized care', offers natural advantages to general practitioners in managing undifferentiated diseases. As general medicine continues to evolve, more experts recognize the expertise of general practitioners in diagnosing and treating medically unspecified diseases. They suggest that general medicine departments in general hospitals should serve as MUD diagnosis and treatment centers, and establish and enhance mechanisms for diagnosing and treating MUD to provide comprehensive care for patients

[3]

4.1. General Situation Analysis

Foreign studies have indicated a higher prevalence of medically unspecified disease (MUD) in young and middle-aged individuals compared to other age groups

[5]

. The average age of patients in this study was (44.97±13.50) years, aligning with findings from international research. The largest proportion of patients fell within the 45-65 age bracket, reflecting the aging population and increased life expectancy. Previous studies have shown that individuals with MUD experience a diminished quality of life, impaired daily functioning, and often undergo unnecessary medical procedures. These risks escalate with age, suggesting a rising prevalence of MUD among older, more vulnerable individuals who may not receive adequate attention or care

[6]

. Research by Pu Jiaxin et al.

[7]

revealed that elderly patients with chronic illnesses are more susceptible to anxiety and depression. In this study, females accounted for 54.5% of patients, consistent with previous MUD epidemiological surveys. However, there was no significant difference in the age distribution of MUD patients between genders, contrary to prior findings. Notably, there were more female patients than male patients in the 45 to 65 age group. Both domestic and foreign surveys have demonstrated a significantly higher prevalence of MUD in women aged 36-55 compared to men

[6]

, possibly attributed to the dual responsibilities of family and work that women in this age group typically bear, leading to increased psychological and emotional stress.

4.2. Analysis of MUD Symptoms, Consultation, and Follow-up Status

Medically unspecified diseases can affect various systems of the body, such as respiratory, digestive, neurological, psychological, skeletal, and others. This study examined 22 medical symptoms, with the top five symptoms, including chest pain, abdominal pain, chest tightness, fatigue, and dizziness, accounting for 82.6% of all symptoms. Research by Zhou Zhonghua et al.

[8]

on general medicine outpatients in tertiary general hospitals also highlighted abdominal pain, cough, low back discomfort, chest pain, and fatigue as common symptoms

[9]

. Specifically, chest pain was the most common symptom leading to medical consultation in this study, with more men than women seeking treatment in specialist outpatient clinics. Follow-up data within 1 year showed that most patients did not seek further treatment or had minimal follow-up visits. The study also noted a higher prevalence of undiagnosed patients compared to diagnosed ones, with patients experiencing chest pain reporting higher anxiety scores than those with other symptoms. Chest pain is a common reason for outpatient and emergency visits, with non-cardiac chest pain accounting for 50% to 75% of cases

[10, 11]

. Various causes of non-cardiac chest pain exist, including chest wall diseases, digestive system diseases, and mental disorders

[12]

. The 10th edition of the International Classification of Diseases (ICD-10) categorizes non-cardiac chest pain as unspecified chest pain, precordial pain, and other types. Mental disorders like depression and anxiety can exacerbate chest pain symptoms, highlighting the importance of evaluating mental status and providing appropriate treatment. Research indicates that a significant number of chest pain patients remain undiagnosed, with higher anxiety scores compared to patients with other medically unexplained symptoms. Research by Qu Shan et al.

[13]

shows that 23% of patients with non-cardiac chest pain suffer from anxiety disorders and 42% suffer from depressive disorders. Identifying and addressing anxiety and depression is crucial in managing non-cardiac chest pain. As general medicine departments in hospitals expand and general practitioners focus more on undifferentiated diseases, an increasing number of patients with medically unexplained symptoms are seeking care in these settings. Research conducted by Zhao Wenwen et al.

[14]

and others has indicated that the majority of MUD patients may benefit from treatment in the general medicine department of general hospitals. Patients and their families tend to report higher levels of satisfaction with general medical staff and exhibit higher rates of follow-up compared to specialists. However, this particular study found that patients experiencing chest pain did not seek medical attention again within a year and had more than one or two doctor visits, which contrasts with the findings of previous research. It is suggested that the absence of significant abnormalities in patient-related test results led to successful alleviation of patient anxiety through careful communication during consultations with the general practitioner. Nevertheless, further studies are needed to validate these findings. Another study by Liu Guoqing et al.

[15]

and colleagues has shown that anxiety reactions tend to be more pronounced after smoking cessation. Moreover, this study proposes that female patients, non-smokers, and medical staff may self-report higher levels of anxiety, with no significant correlation observed between self-reported anxiety and age.

To sum up, medically unspecified diseases have emerged as a significant focus within the field of general medicine, emphasizing the complexity and variability of symptoms. Despite this, a standardized diagnostic and treatment approach for these conditions has yet to be established. General medicine departments in hospitals now serve as the primary battleground for managing undifferentiated diseases. It is crucial for general practitioners to leverage their expertise not only in addressing the disease itself but also in evaluating the emotional and psychological well-being of patients, in order to offer comprehensive diagnostic and treatment services. However, this study has several limitations, including being conducted at a single center with a relatively small sample size and lacking a detailed follow-up plan. Future research should involve multi-center studies with larger sample sizes and more comprehensive research plans, such as exploring the relationship between anxiety, depression, and undifferentiated diseases. This will provide a stronger foundation for the diagnosis and treatment of undifferentiated diseases in general medicine departments of tertiary hospitals.

5. Conclusion

MUD patients have various reasons for seeking medical treatment. General practitioners in comprehensive tertiary hospitals, while focusing on general examination results, should perhaps provide a more specialized assessment of patients' psychological conditions. This would further standardize the diagnosis and treatment process for MUD and offer more comprehensive medical services to patients.

Abbreviations

MUD	Medically Unspecified Disease
MUS	Medically Unexplained Symptoms
ICD-10	The 10th Edition of the International Classification of Diseases

Author Contributions

Shuang Xu: Conceptualization, Resources, Writing – original draft

Jing Liu: Data curation, Methodology, Formal analysis

Yun Chen: Data curation, Investigation

Qing Zhang: Project administration, Supervision

Conflicts of Interest

There is no conflict of interest in this article.

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Xu, S., Liu, J., Chen, Y., Zhang, Q. (2024). Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital. American Journal of Clinical and Experimental Medicine, 12(4), 45-51. https://doi.org/10.11648/j.ajcem.20241204.11

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ACS Style

Xu, S.; Liu, J.; Chen, Y.; Zhang, Q. Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital. Am. J. Clin. Exp. Med. 2024, 12(4), 45-51. doi: 10.11648/j.ajcem.20241204.11

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AMA Style

Xu S, Liu J, Chen Y, Zhang Q. Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital. Am J Clin Exp Med. 2024;12(4):45-51. doi: 10.11648/j.ajcem.20241204.11

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@article{10.11648/j.ajcem.20241204.11,
  author = {Shuang Xu and Jing Liu and Yun Chen and Qing Zhang},
  title = {Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital
},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {12},
  number = {4},
  pages = {45-51},
  doi = {10.11648/j.ajcem.20241204.11},
  url = {https://doi.org/10.11648/j.ajcem.20241204.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20241204.11},
  abstract = {Background Patients with medically unspecified disease (MUD) may present at any disease stage, with clinical manifestations and test results that do not lead to a clear diagnosis, posing a common challenge in clinical settings. General practitioners, with their patient-centered approach and holistic medical models, have an advantage in diagnosing and treating MUD. Standardizing the diagnosis and treatment of MUD is a crucial skill for general practitioners. However, there is currently a lack of data on the treatment of MUD in general outpatient clinics of comprehensive tertiary hospitals. Objective This study examines the prevalence of medically unexplained symptoms (MUS) in general outpatient clinics, offering insights for general practitioners in tertiary hospitals on diagnosing and treating MUS. It also serves as a foundation for standardizing the diagnostic and treatment protocols for MUD. Methods Select patients diagnosed with medically unspecified disease (MUD) who visited the outpatient department of our general medicine department between September 2021 and September 2022. Collect basic information and follow-up data for one year post-visit, and analyze the reasons for the initial visit and subsequent follow-up outcomes. Results A total of 576 patients with MUD received treatment at the general outpatient department, with an average age of (44.97 ± 13.50) years. There was no statistically significant difference in the age distribution among male and female MUD patients (P > 0.05). Chest pain was the most common reason for treatment of medically unspecified disease in the general outpatient department. Among patients treated for chest pain, there were more males than females (P < 0.05), and a greater number of patients were treated in specialized clinics compared to general clinics (P < 0.05), The majority of patients remained undiagnosed and had either 0 or no more than 2 visits within a year. There was no significant correlation between anxiety scores and age, although female patients, those with chest pain, healthcare staff, and non-smokers reported higher levels of self-anxiety. Conclusion MUD patients have various reasons for seeking medical treatment. General practitioners in comprehensive tertiary hospitals should make full use of relevant resources, attach importance to the full evaluation of the psychological status of MUD patients, standardize the diagnosis and treatment process of MUD, and provide more comprehensive diagnosis and treatment services.
},
 year = {2024}
}

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SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20241204.11
AB  - Background Patients with medically unspecified disease (MUD) may present at any disease stage, with clinical manifestations and test results that do not lead to a clear diagnosis, posing a common challenge in clinical settings. General practitioners, with their patient-centered approach and holistic medical models, have an advantage in diagnosing and treating MUD. Standardizing the diagnosis and treatment of MUD is a crucial skill for general practitioners. However, there is currently a lack of data on the treatment of MUD in general outpatient clinics of comprehensive tertiary hospitals. Objective This study examines the prevalence of medically unexplained symptoms (MUS) in general outpatient clinics, offering insights for general practitioners in tertiary hospitals on diagnosing and treating MUS. It also serves as a foundation for standardizing the diagnostic and treatment protocols for MUD. Methods Select patients diagnosed with medically unspecified disease (MUD) who visited the outpatient department of our general medicine department between September 2021 and September 2022. Collect basic information and follow-up data for one year post-visit, and analyze the reasons for the initial visit and subsequent follow-up outcomes. Results A total of 576 patients with MUD received treatment at the general outpatient department, with an average age of (44.97 ± 13.50) years. There was no statistically significant difference in the age distribution among male and female MUD patients (P > 0.05). Chest pain was the most common reason for treatment of medically unspecified disease in the general outpatient department. Among patients treated for chest pain, there were more males than females (P < 0.05), and a greater number of patients were treated in specialized clinics compared to general clinics (P < 0.05), The majority of patients remained undiagnosed and had either 0 or no more than 2 visits within a year. There was no significant correlation between anxiety scores and age, although female patients, those with chest pain, healthcare staff, and non-smokers reported higher levels of self-anxiety. Conclusion MUD patients have various reasons for seeking medical treatment. General practitioners in comprehensive tertiary hospitals should make full use of relevant resources, attach importance to the full evaluation of the psychological status of MUD patients, standardize the diagnosis and treatment process of MUD, and provide more comprehensive diagnosis and treatment services.

VL  - 12
IS  - 4
ER  -

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Author Information

Shuang Xu

Department of General Practice, Affiliated Hospital 2 of Nantong University, Nantong, China

http://orcid.org/0009-0009-3222-8740
Jing Liu

Department of Oncology, Affiliated Hospital 2 of Nantong University, Nantong, China

http://orcid.org/0000-0002-0480-9478
Yun Chen

Department of General Practice, Affiliated Hospital 2 of Nantong University, Nantong, China

http://orcid.org/0009-0007-4893-4776
Qing Zhang

Department of General Practice, Affiliated Hospital 2 of Nantong University, Nantong, China

Contact Email

http://orcid.org/0000-0003-4666-2547

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APA Style

Xu, S., Liu, J., Chen, Y., Zhang, Q. (2024). Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital. American Journal of Clinical and Experimental Medicine, 12(4), 45-51. https://doi.org/10.11648/j.ajcem.20241204.11

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ACS Style

Xu, S.; Liu, J.; Chen, Y.; Zhang, Q. Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital. Am. J. Clin. Exp. Med. 2024, 12(4), 45-51. doi: 10.11648/j.ajcem.20241204.11

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AMA Style

Xu S, Liu J, Chen Y, Zhang Q. Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital. Am J Clin Exp Med. 2024;12(4):45-51. doi: 10.11648/j.ajcem.20241204.11

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@article{10.11648/j.ajcem.20241204.11,
  author = {Shuang Xu and Jing Liu and Yun Chen and Qing Zhang},
  title = {Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital
},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {12},
  number = {4},
  pages = {45-51},
  doi = {10.11648/j.ajcem.20241204.11},
  url = {https://doi.org/10.11648/j.ajcem.20241204.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20241204.11},
  abstract = {Background Patients with medically unspecified disease (MUD) may present at any disease stage, with clinical manifestations and test results that do not lead to a clear diagnosis, posing a common challenge in clinical settings. General practitioners, with their patient-centered approach and holistic medical models, have an advantage in diagnosing and treating MUD. Standardizing the diagnosis and treatment of MUD is a crucial skill for general practitioners. However, there is currently a lack of data on the treatment of MUD in general outpatient clinics of comprehensive tertiary hospitals. Objective This study examines the prevalence of medically unexplained symptoms (MUS) in general outpatient clinics, offering insights for general practitioners in tertiary hospitals on diagnosing and treating MUS. It also serves as a foundation for standardizing the diagnostic and treatment protocols for MUD. Methods Select patients diagnosed with medically unspecified disease (MUD) who visited the outpatient department of our general medicine department between September 2021 and September 2022. Collect basic information and follow-up data for one year post-visit, and analyze the reasons for the initial visit and subsequent follow-up outcomes. Results A total of 576 patients with MUD received treatment at the general outpatient department, with an average age of (44.97 ± 13.50) years. There was no statistically significant difference in the age distribution among male and female MUD patients (P > 0.05). Chest pain was the most common reason for treatment of medically unspecified disease in the general outpatient department. Among patients treated for chest pain, there were more males than females (P < 0.05), and a greater number of patients were treated in specialized clinics compared to general clinics (P < 0.05), The majority of patients remained undiagnosed and had either 0 or no more than 2 visits within a year. There was no significant correlation between anxiety scores and age, although female patients, those with chest pain, healthcare staff, and non-smokers reported higher levels of self-anxiety. Conclusion MUD patients have various reasons for seeking medical treatment. General practitioners in comprehensive tertiary hospitals should make full use of relevant resources, attach importance to the full evaluation of the psychological status of MUD patients, standardize the diagnosis and treatment process of MUD, and provide more comprehensive diagnosis and treatment services.
},
 year = {2024}
}

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TY  - JOUR
T1  - Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital

AU  - Shuang Xu
AU  - Jing Liu
AU  - Yun Chen
AU  - Qing Zhang
Y1  - 2024/10/31
PY  - 2024
N1  - https://doi.org/10.11648/j.ajcem.20241204.11
DO  - 10.11648/j.ajcem.20241204.11
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 45
EP  - 51
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20241204.11
AB  - Background Patients with medically unspecified disease (MUD) may present at any disease stage, with clinical manifestations and test results that do not lead to a clear diagnosis, posing a common challenge in clinical settings. General practitioners, with their patient-centered approach and holistic medical models, have an advantage in diagnosing and treating MUD. Standardizing the diagnosis and treatment of MUD is a crucial skill for general practitioners. However, there is currently a lack of data on the treatment of MUD in general outpatient clinics of comprehensive tertiary hospitals. Objective This study examines the prevalence of medically unexplained symptoms (MUS) in general outpatient clinics, offering insights for general practitioners in tertiary hospitals on diagnosing and treating MUS. It also serves as a foundation for standardizing the diagnostic and treatment protocols for MUD. Methods Select patients diagnosed with medically unspecified disease (MUD) who visited the outpatient department of our general medicine department between September 2021 and September 2022. Collect basic information and follow-up data for one year post-visit, and analyze the reasons for the initial visit and subsequent follow-up outcomes. Results A total of 576 patients with MUD received treatment at the general outpatient department, with an average age of (44.97 ± 13.50) years. There was no statistically significant difference in the age distribution among male and female MUD patients (P > 0.05). Chest pain was the most common reason for treatment of medically unspecified disease in the general outpatient department. Among patients treated for chest pain, there were more males than females (P < 0.05), and a greater number of patients were treated in specialized clinics compared to general clinics (P < 0.05), The majority of patients remained undiagnosed and had either 0 or no more than 2 visits within a year. There was no significant correlation between anxiety scores and age, although female patients, those with chest pain, healthcare staff, and non-smokers reported higher levels of self-anxiety. Conclusion MUD patients have various reasons for seeking medical treatment. General practitioners in comprehensive tertiary hospitals should make full use of relevant resources, attach importance to the full evaluation of the psychological status of MUD patients, standardize the diagnosis and treatment process of MUD, and provide more comprehensive diagnosis and treatment services.

VL  - 12
IS  - 4
ER  -

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