Updated ATA 2025: TSH is the single best screening test.
SOP:
Diseases in this SOP require updates every 12–24 months. For example, in 2024 alone, criteria for hypertension, MASLD, and AF underwent major changes.
Updated Golden Rule: CT perfusion within 25 minutes of arrival. sop for diagnosis of top 20 common diseases updated
SOP:
Focused history (time course, severity, risk factors)
Focused physical exam targeted to presenting problem Updated ATA 2025: TSH is the single best screening test
Generate prioritized differential (top 3–5)
Apply validated clinical decision rules where available
Targeted diagnostic testing
Interpret results in clinical context
Management decision & disposition
Documentation & communication
Follow-up & safety netting
| Disease | Minimum Required for Diagnosis | Key Update | |---------|-------------------------------|-------------| | Hypertension | Two seated BP readings >130/80 (ACC/AHA 2017) or >140/90 (ESC 2018) on 3 separate visits | Confirm with 24-hr ambulatory BP monitoring | | Type 2 DM | FPG ≥126 mg/dL OR HbA1c ≥6.5% OR 2-hr OGTT ≥200 mg/dL | HbA1c preferred but caution in anemia | | URTI | Clinical (no routine throat culture unless Centor criteria ≥3) | Avoid antibiotics; test COVID/influenza if high risk | | UTI | Urinalysis (nitrites, leukocytes) + symptoms; culture only if recurrent, pregnancy, or men | Do not treat asymptomatic bacteriuria except pregnancy | | Ischemic Heart Disease | ECG + high-sensitivity troponin (0/1h or 0/2h algorithm) + Chest pain history | Use HEART score for ED triage | | COPD | Post-bronchodilator FEV1/FVC <0.70 + smoking history | No routine spirometry in acute exacerbation | | Appendicitis | Alvarado score (≥7 for surgery) + CT if equivocal | Ultrasound first in children/pregnancy |