When all you have is a hammer, everything has to be a nail
Managing diagnostic uncertainty in urinary tract infection
Bibliographic Data
| ID | 2250384 |
|---|---|
| Authors | Eleanor Kashouris (0000-0001-6985-8011, School of Geography Politics and Sociology Newcastle University Newcastle upon Tyne UK, corresponding author) |
| Year | 2024 |
| Volume | 46 |
| Issue | 8 |
| Pages | 1668-1685 |
| Publication date | 2024-11-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Sociology of Health & Illness (JOURNAL) |
| Journal identifiers | ISSN: 0141-9889 • E-ISSN: 1467-9566 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/1467-9566.13803 |
| PMID | 38829769 |
| OpenAlex | W4399284057 |
| Language | EN |
| Citations received | 2 |
| References cited | 40 |
Diagnosis of urinary tract infections (UTI) is a routine part of medical work and yet is well recognised to be an area of high clinical uncertainty. Meanwhile, diagnosis of UTI is becoming increasingly important to policymakers globally due to concerns about antibiotic over-prescription. Drawing on Mol's concept of ontological multiplicity in clinical work, I explore how diagnostic uncertainty is co-ordinated into certainty by a UK national diagnostic algorithm for UTI. The diagnosis of UTI is produced or withheld as a post hoc rationalisation of a prior decision whether to prescribe antibiotics or not. Work in the sociology of diagnosis has already noted that diagnostic steps are often re-ordered by health-care professionals taking diverse actions in the best interest of their patients. This article contributes an argument that ordering diagnostic work around antimicrobial stewardship agendas has the effect of narrowing possible actions. Exploring the consequences and effects of doing diagnosis in this way for different groups, I argue that a greater creativity about what could be done to care for painful bladders could be found in a return to more clinical ways of working
Antibiotic resistance · Antibiotics · Antimicrobial stewardship · Argument (complex analysis · Diagnostic test · Intensive care medicine · Rationalisation · Urinary system · Antibiotic Use and Resistance · Bacterial Identification and Susceptibility Testing · Internal Medicine · Medicine · Urinary Tract Infections Management · Pediatrics
Science in action
The Logic of Care
Grounded Theory
Putting a Name to It
Sorting Things Out
On difference and doubt as tools for critical engagement with public health
Artefacts of not-knowing
Using Institutional Ethnography to Understand the Production of Health Care Disparities
Antibiotic Resistance and the Biology of History
The Body Multiple
Diagnosis as Topic and as Resource
| Citations per year | 2 |
|---|---|
| Citation span | 2025 - 2025 (1) |
| Highly cited | No |