Classical neurology teaching highlighted that investigations make a very small contribution to the diagnosis; we were therefore encouraged to focus on our clinical skills, and particularly the history. However, the development of increasingly sophisticated diagnostic techniques, particularly in imaging and genetics, has made us rely more on investigations in coming to a diagnosis. Several factors encourage indiscriminate testing, including the pressure for prompt diagnosis, the limited opportunity for follow up and risk-averse practice driven by increased litigation. Instead of focussing initially on the most likely diagnosis, and then using serial investigations parsimoniously, we feel pushed into running parallel investigations to cover all scenarios, including testing for very rare and unlikely entities. A single broad battery of tests at the outset helps to reassure us that ‘everything is done, and nothing forgotten’. Clinical Grand Rounds are very educational, but the presentation of rare and challenging cases mean the wrong lessons are learnt, with an appreciation of the clinical reasoning used losing out to a need to ‘do all the tests’. The resulting overuse of tests is now widely recognised and has prompted the …

中文翻译：

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不要做血液*测试！！

经典神经病学教学强调调查对诊断的贡献很小；因此，我们被鼓励专注于我们的临床技能，尤其是历史。然而，日益复杂的诊断技术的发展，特别是在成像和遗传学方面，使我们在诊断时更加依赖调查。有几个因素鼓励不加区分的测试，包括及时诊断的压力、有限的跟进机会以及因诉讼增加而导致的规避风险的做法。与其最初关注最有可能的诊断，然后以简约的方式使用连续调查，我们感到被迫进行并行调查以涵盖所有场景，包括对非常罕见和不太可能的实体进行测试。一开始就进行一系列广泛的测试有助于让我们放心，“一切都已完成，没有忘记任何事情”。临床大回合非常有教育意义，但对罕见和具有挑战性的案例的介绍意味着吸取了错误的教训，对所使用的临床推理进行了评估，而不是“做所有测试”的需要。由此导致的过度使用测试现已得到广泛认可，并促使……