Evidence map›Paper›PMID 42633344›Full record

ArticleFuture healthcare journal2026

Make diagnostic doubt visible in healthcare.

Myeat Chel, Minha Rajput-Ray, Kiran Jani, Christianne Forrest, Jennifer McCallum, Adrian Tookman, Steven Walker

Abstract read
In one paragraph

Article in Future healthcare journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Myeat ChelSRH University, Berlin, Germany.
Minha Rajput-RayCuraidh Clinic, Dundee, Scotland, UK.
Kiran JaniNational Ethics Network, Cambridge, UK.
Christianne ForrestPatient Advocate with Lived Experiences, Swansea, UK.
Jennifer McCallumSt Gilesmedical, London, UK.
Adrian TookmanForgotten Patients, Overlooked Diseases Charity, London, UK.
Steven WalkerUniversity College London, Forgotten Patients, Overlooked Diseases Charity, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with persistent debilitating symptoms and normal test results can face a diagnostic odyssey that harms both individuals and healthcare systems. Current frameworks use many labels to categorise suffering in these people; one example being 'persistent physical symptoms' (PPS). Though helpful provisional descriptors, these labels can create diagnostic ceilings, leaving patients abandoned without follow-up or hope. This article argues that medicine's difficulty managing uncertainty creates iatrogenic harm, erodes trust, and can drive healthcare avoidance. We propose a paradigm shift from seeking rapid diagnostic closure to legitimising skilled diagnostic doubt through coded clinical positions such as Systematised Nomenclature of Medicine - Clinical Terms (SNOMED CT)'s 'Uncertain diagnosis'. This requires integrated strategies combining advanced diagnostics, mandatory clinician training in uncertainty and communication, named care coordinators, and ring-fenced research funding. Drawing on recent analyses and patient testimony, we contend that making diagnostic doubt visible is not merely an administrative change but an ethical imperative. Transforming abandonment into advocacy through curiosity-driven; continuous care must not be postponed.

Indexed as

Diagnostic doubtFunctional symptomsMedically unexplained symptomOptimising patient carePersistent physical symptoms

Identifiers

PMID42633344
PMCPMC13499390

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.