Table 1 Sample vignettes

RA with pain, stiffness and swelling

 Increasingly you find it difficult to get out of bed in the mornings and move around because your joints are very stiff. In particular your finger joints and wrist joint are painful and they hurt most when you wake in the morning, but the pain can last all day. As a consequence of the stiffness you take longer than usual to get out of bed, and it can take some time before the stiffness subsides, and you are able to move around without much difficulty. You look at your wrist, knees, and hands and you notice that some of your joints are swollen and are sensitive to touch. You have not experienced these symptoms before.

Bowel cancer

 You visit the bathroom and notice that there is blood in your stools. This has happened several times over the last month. Recently you’ve been going to the toilet more often and have had some diarrhoea. You have also noticed that you have been losing weight, which is unusual because your appetite has been normal and you have not been exercising more than normal. You are also feeling run down and very tired.