TY - JOUR T1 - Highlights from this issue JF - Practical Neurology JO - Pract Neurol SP - 175 LP - 175 DO - 10.1136/practneurol-2022-003476 VL - 22 IS - 3 AU - Phil E M Smith AU - Geraint N Fuller Y1 - 2022/06/01 UR - http://pn.bmj.com/content/22/3/175.abstract N2 - To make a decision is to answer a question. Clinical neurology involves a sequence of questions relevant to most patients—what is the clinical syndrome? what investigations are needed? what is the probable diagnosis? what is the best treatment? what is the likely prognosis? This is how students and trainee doctors are taught to structure their clinical questioning, and how clinical case vignettes are presented in final or postgraduate exams. Though these exam vignettes are slightly deceptive as the case summary is designed to include all the appropriate information that can lead to a decision—a diagnosis or treatment.A primary care physician’s letter often reads like such a vignette, typically providing enough information to make a diagnosis or to plan the next steps in investigation. ‘Advice and Guidance’ is a system that recognises that this occurs quite often; it is designed to allow neurologists to provide advice on diagnosis, investigation or management in collaboration with primary care. This allows patients to start their investigations or … ER -