From the Guidelines
A good work-up for a patient involves a comprehensive assessment, including a detailed history taking, thorough physical examination, and appropriate laboratory and imaging tests, as outlined in the most recent guidelines, such as those from the American Society of Clinical Oncology 1. The work-up should start with a detailed history taking, including chief complaint, history of present illness, past medical history, medications, allergies, family history, and social history.
- This should be followed by a thorough physical examination focusing on relevant body systems.
- Laboratory tests, such as complete blood count, comprehensive metabolic panel, urinalysis, and specific tests based on suspected conditions, should be ordered.
- Imaging studies, such as X-rays, ultrasound, CT scans, or MRIs, should be included when indicated.
- Specialized tests, like electrocardiograms, pulmonary function tests, or endoscopies, should be considered depending on symptoms. The work-up should be tailored to the patient's specific presentation while being comprehensive enough to identify the underlying cause of their symptoms, as recommended by recent studies 1. The most recent and highest quality study, such as the 2021 ASCO guideline update 1, should be prioritized when making a definitive recommendation, and the work-up should include pulse oximetry and CT chest preferably with contrast if concerned for other etiologies, as well as infectious workup and COVID-19 evaluation as needed.
From the Research
Components of a Good Work Up
A good work up involves several key components, including:
- Taking a comprehensive patient history
- Conducting physical assessments
- Ordering laboratory investigations
Importance of History Taking
History taking is a crucial part of the work up process, as it allows healthcare professionals to gather relevant information from patients and inform diagnosis and treatment 2. This process is structured but flexible, and requires important communication skills such as:
- Active listening
- Empathetic communication
- Cultural sensitivity
Benefits of Comprehensive History Taking
By taking a thorough patient history, healthcare professionals can:
- Make accurate diagnoses
- Develop effective management plans
- Facilitate patient participation and autonomy in their care 2