Medical diagnosis
Encyclopedia
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease
or disorder
(and diagnosis in this sense can also be termed (medical) diagnostic procedure), and to the opinion reached by this process (also being termed (medical) diagnostic opinion). From the point of view of statistics the diagnostic procedure involves classification tests. It is a major component of, for example, the procedure of a doctor's visit.
The plural of diagnosis is diagnoses, the verb is to diagnose, and a person who diagnoses is called a diagnostician. The word diagnosis (daɪ.əɡˈnoʊsɨs) is derived through Latin
from the Greek
word διαγιγνώσκειν, meaning to discern or distinguish. This Greek word is formed from διά, meaning apart, and γιγνώσκειν, meaning to perceive.
of a an individual's condition into separate and distinct categories that allow medical decisions about treatment and prognosis to be made. Subsequently, a diagnostic opinion is often described in terms of a disease or other condition, but in the case of a wrong diagnosis, the individual's actual disease or condition is not the same as the individual's diagnosis.
A diagnostic procedure may be performed by various health care professionals such as a physician
, physical therapist, chiropractor
, healthcare scientist
, dentist
, podiatrist, nurse practitioner
, or physician assistant
s. This article uses diagnostician as any of these person categories.
A diagnostic procedure (as well as the opinion reached thereby) does not necessarily involve elucidation of the etiology
of the diseases or conditions of interest, that is, what caused the disease or condition. Such further elucidation can, however, be useful to optimize treatment, further specify the prognosis or prevent recurrence of the disease or condition in the future.
It should be noted, however, that medical diagnosis in psychology or psychiatry is problematic. There are differing theoretical views toward mental conditions and few objective tests available for various major disorders (e.g., clinical depression), so a causal analysis with respect to symptomatology and disorder/disease is not always possible. As a result, most if not all mental conditions function as both symptoms and disorders. There are often functional descriptions provided for psychological disorders and these are vulnerable to circular reasoning due to the etiological fuzziness inherent of these diagnostic categories. (BDG, 2006)
to perform a diagnostic procedure. Indications include:
Even during an already ongoing diagnostic procedure, there can be an indication to perform another, separate, diagnostic procedure for another, potentially concomitant, disease or condition. This may occur as a result of an incidental finding of a sign unrelated to the parameter of interest, such as can occur in comprehensive tests such as radiological
studies like magnetic resonance imaging
or blood test
panels that also include blood tests that are not relevant for the ongoing diagnosis.
or following medical algorithm
s. In reality, a diagnostic procedure may involve components of multiple methods.
or at least of rendering the entries more or less probable by further medical test
s and other processing until, aiming to reach the point where only one candidate disease or condition remains as probable. The final result may also remain a list of possible conditions, ranked in order of probability or severity.
The resultant diagnostic opinion by this method can be regarded more or less as a diagnosis of exclusion
. Even if it doesn't result in a single probable disease or condition, it can at least rule out any imminently life-threatening conditions.
Unless the provider is certain of the condition present, further medical tests, such as medical imaging, are performed or scheduled in part to confirm or disprove the diagnosis but also to document the patient's status and keep the patient's medical history up to date.
If unexpected findings are made during this process, the initial hypothesis may be ruled out and the provider must then consider other hypotheses.
method the provider uses experience to recognize a pattern of clinical characteristics. It is mainly based on certain symptoms or signs being associated
with certain diseases or conditions, not necessarily involving the more cognitive processing involved in a differential diagnosis.
This may be the primary method used in cases where diseases are "obvious", or the provider's experience may enable him or her to recognize the condition quickly. Theoretically, a certain pattern of signs or symptoms can be directly associated with a certain therapy, even without a definite decision regarding what is the actual disease, but such a compromise carries a substantial risk of missing a diagnosis which actually has a different therapy so it may be limited to cases where no diagnosis can be made.
s, and test results that the clinician uses to attempt to determine the correct diagnosis.
Some examples of diagnostic criteria are:
s are interactive computer programs designed to assist health professionals with decision-making tasks. The clinician interacts with the software utilizing both the clinician’s knowledge and the software to make a better analysis of the patients data than either human or software could make on their own. Typically the system makes suggestions for the clinician to look through and the clinician picks useful information and removes erroneous suggestions.
, progression, prognosis
, other outcomes, and possible treatments of her or his ailments, as well as providing advice for maintaining health.
A treatment plan is proposed which may include therapy and follow-up consultations and tests to monitor
the condition and the progress of the treatment, if needed, usually according to the medical guidelines provided by the medical field on the treatment of the particular illness.
Relevant information should be added to the medical record
of the patient.
A failure to respond to treatments that would normally work may indicate a need for review of the diagnosis.
Clinical diagnosis
Laboratory diagnosis
Radiology diagnosis
Principal diagnosis
Admitting diagnosis
Differential diagnosis
Diagnostic criteria
Prenatal diagnosis
Diagnosis of exclusion
Dual diagnosis
Self-diagnosis
Remote diagnosis
Nursing diagnosis
Computer-aided diagnosis
Overdiagnosis
Wastebasket diagnosis
Retrospective diagnosis
) and treatments that may cause harm. Overdiagnosis occurs when a disease is diagnosed correctly, but the diagnosis is irrelevant. A correct diagnosis may be irrelevant because treatment for the disease is not available, not needed, or not wanted.
of a disease or condition is made. Types of lag times are mainly:
in ancient Egypt
and Hippocrates
in ancient Greece
. In Traditional Chinese Medicine, there are four diagnostic methods: inspection, auscultation-olfaction, interrogation, and palpation. A Babylonia
n medical textbook, the Diagnostic Handbook written by Esagil-kin-apli (fl.
1069-1046 BC), introduced the use of empiricism
, logic
and rationality
in the diagnosis of an illness or disease. The book made use of logical rules in combining observed symptoms on the body of a patient with its diagnosis and prognosis
. Esagil-kin-apli described the symptoms for many varieties of epilepsy
and related ailments along with their diagnosis and prognosis.
The practice of diagnosis continues to be dominated by theories set down in the early 20th century.
:Category:Diseases
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
or disorder
Disorder
Disorder may refer to :* Chaos, unpredictability and in the metaphysical sense, it is the opposite of law and order* Civil disorder, one or more forms of disturbance caused by a group of people...
(and diagnosis in this sense can also be termed (medical) diagnostic procedure), and to the opinion reached by this process (also being termed (medical) diagnostic opinion). From the point of view of statistics the diagnostic procedure involves classification tests. It is a major component of, for example, the procedure of a doctor's visit.
The plural of diagnosis is diagnoses, the verb is to diagnose, and a person who diagnoses is called a diagnostician. The word diagnosis (daɪ.əɡˈnoʊsɨs) is derived through Latin
Latin
Latin is an Italic language originally spoken in Latium and Ancient Rome. It, along with most European languages, is a descendant of the ancient Proto-Indo-European language. Although it is considered a dead language, a number of scholars and members of the Christian clergy speak it fluently, and...
from the Greek
Greek language
Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...
word διαγιγνώσκειν, meaning to discern or distinguish. This Greek word is formed from διά, meaning apart, and γιγνώσκειν, meaning to perceive.
Overview
A diagnosis, in the sense of diagnostic procedure, can be regarded as an attempt at classificationClassification
Classification may refer to:* Library classification and classification in general* Taxonomic classification * Biological classification of organisms* Medical classification* Scientific classification...
of a an individual's condition into separate and distinct categories that allow medical decisions about treatment and prognosis to be made. Subsequently, a diagnostic opinion is often described in terms of a disease or other condition, but in the case of a wrong diagnosis, the individual's actual disease or condition is not the same as the individual's diagnosis.
A diagnostic procedure may be performed by various health care professionals such as a physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
, physical therapist, chiropractor
Chiropractor
A Chiropractor, according to the Association of Chiropractic Colleges , "focuses on the relationship between the body's main structures – the skeleton, the muscles and the nerves – and the patient's health. Chiropractors believe that health can be improved and preserved by making adjustments to...
, healthcare scientist
Healthcare science
Healthcare science is the applied science dealing with the application of science, technology, engineering or mathematics to the delivery of healthcare....
, dentist
Dentist
A dentist, also known as a 'dental surgeon', is a doctor that specializes in the diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aides in providing oral health services...
, podiatrist, nurse practitioner
Nurse practitioner
A Nurse Practitioner is an Advanced practice registered nurse who has completed graduate-level education . Additional APRN roles include the Certified Registered Nurse Anesthetist s, CNMs, and CNSs...
, or physician assistant
Physician assistant
A physician assistant/associate ' is a healthcare professional trained and licensed to practice medicine with limited supervision by a physician.-General description:...
s. This article uses diagnostician as any of these person categories.
A diagnostic procedure (as well as the opinion reached thereby) does not necessarily involve elucidation of the etiology
Etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
of the diseases or conditions of interest, that is, what caused the disease or condition. Such further elucidation can, however, be useful to optimize treatment, further specify the prognosis or prevent recurrence of the disease or condition in the future.
It should be noted, however, that medical diagnosis in psychology or psychiatry is problematic. There are differing theoretical views toward mental conditions and few objective tests available for various major disorders (e.g., clinical depression), so a causal analysis with respect to symptomatology and disorder/disease is not always possible. As a result, most if not all mental conditions function as both symptoms and disorders. There are often functional descriptions provided for psychological disorders and these are vulnerable to circular reasoning due to the etiological fuzziness inherent of these diagnostic categories. (BDG, 2006)
Indication for diagnostic procedure
The initial task is to detect a medical indicationIndication (medicine)
In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. The opposite of indication is contraindication.-Drugs:...
to perform a diagnostic procedure. Indications include:
- Detection of any deviation from what is known to be normal, such as can be described in terms of, for example, anatomyAnatomyAnatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...
(the structure of the human body), physiologyPhysiologyPhysiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
(how the body works), pathologyPathologyPathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
(what can go wrong with the anatomy and physiology), psychologyPsychologyPsychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
(thought and behavior) and human homeostasisHuman homeostasisHuman homeostasis is derived from the Greek, homeo or "same", and stasis or "stable" and means remaining stable or remaining the same.The human body manages a multitude of highly complex interactions to maintain balance or return systems to functioning within a normal range...
(regarding mechanisms to keep body systems in balance). Knowledge of what is normal and measuring of the patient's current condition against those norms can assist in determining the patient's particular departure from homeostasis and the degree of departure, which in turn can assist in quantifying the indication for further diagnostic processing. - A complaint expressed by a patient.
- The fact that a patient has sought a diagnostician can itself be an indication to perform a diagnostic procedure. Therefore, in, for example, a doctor's visitDoctor's visitA doctor's visit, also known as "doctor's office visit" or "physician office visit", is a meeting between a patient with a physician to get health advice or treatment for a symptom or condition...
, the physician may already start performing a diagnostic procedure by, for example, watching the gaitGaitGait is the pattern of movement of the limbs of animals, including humans, during locomotion over a solid substrate. Most animals use a variety of gaits, selecting gait based on speed, terrain, the need to maneuver, and energetic efficiency...
of the patient from the waiting room to the doctor's office even before she or he has started to present any complaints.
Even during an already ongoing diagnostic procedure, there can be an indication to perform another, separate, diagnostic procedure for another, potentially concomitant, disease or condition. This may occur as a result of an incidental finding of a sign unrelated to the parameter of interest, such as can occur in comprehensive tests such as radiological
Radiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...
studies like magnetic resonance imaging
Magnetic resonance imaging
Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...
or blood test
Blood test
A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a needle, or via fingerprick....
panels that also include blood tests that are not relevant for the ongoing diagnosis.
General components
General components, which are present in a diagnostic procedure in most of the various available methods include:- Complementing the already given information with further data gathering, which may include questions of the medical historyMedical historyThe medical history or anamnesis of a patient is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information , with the aim of obtaining information useful in formulating a diagnosis and providing...
(potentially from other people close to the patient as well), physical examinationPhysical examinationPhysical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient...
and various diagnostic tests.
A diagnostic test is any kind of medical testMedical testA diagnostic test is any kind of medical test performed to aid in the diagnosis or detection of disease. For example:* to diagnose diseases, and preferably sub-classify it regarding, for example, severity and treatability...
performed to aid in the diagnosis or detection of disease. Diagnostic tests can also be used to provide prognostic information on people with established disease. - Processing of the answers, findings or other results. Consultations with other providers and specialists in the field may be sought.
Specific methods
There are a number of methods or techniques that can be used in a diagnostic procedure, including performing a differential diagnosisDifferential diagnosis
A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...
or following medical algorithm
Medical algorithm
A medical algorithm is any computation, formula, statistical survey, nomogram, or look-up table, useful in healthcare. Medical algorithms include decision tree approaches to healthcare treatment and also less clear-cut tools aimed at reducing or defining uncertainty.-Scope:Medical algorithms are...
s. In reality, a diagnostic procedure may involve components of multiple methods.
Differential diagnosis
The method of differential diagnosis is based on finding as many candidate diseases or conditions as possible that can possibly cause the signs or symptoms, followed by a process of eliminationProcess of elimination
Process of elimination is a method to identify an entity of interest among several ones by excluding all other entities.-In education testing:...
or at least of rendering the entries more or less probable by further medical test
Medical test
A diagnostic test is any kind of medical test performed to aid in the diagnosis or detection of disease. For example:* to diagnose diseases, and preferably sub-classify it regarding, for example, severity and treatability...
s and other processing until, aiming to reach the point where only one candidate disease or condition remains as probable. The final result may also remain a list of possible conditions, ranked in order of probability or severity.
The resultant diagnostic opinion by this method can be regarded more or less as a diagnosis of exclusion
Diagnosis of exclusion
A diagnosis of exclusion is a medical condition reached by a process of elimination, which may be necessary if presence cannot be established with complete confidence from examination or testing...
. Even if it doesn't result in a single probable disease or condition, it can at least rule out any imminently life-threatening conditions.
Unless the provider is certain of the condition present, further medical tests, such as medical imaging, are performed or scheduled in part to confirm or disprove the diagnosis but also to document the patient's status and keep the patient's medical history up to date.
If unexpected findings are made during this process, the initial hypothesis may be ruled out and the provider must then consider other hypotheses.
Pattern recognition
In a pattern recognitionPattern recognition
In machine learning, pattern recognition is the assignment of some sort of output value to a given input value , according to some specific algorithm. An example of pattern recognition is classification, which attempts to assign each input value to one of a given set of classes...
method the provider uses experience to recognize a pattern of clinical characteristics. It is mainly based on certain symptoms or signs being associated
Association (psychology)
In psychology and marketing, two concepts or stimuli are associated when the experience of one leads to the effects of another, due to repeated pairing. This is sometimes called Pavlovian association for Ivan Pavlov's pioneering of classical conditioning....
with certain diseases or conditions, not necessarily involving the more cognitive processing involved in a differential diagnosis.
This may be the primary method used in cases where diseases are "obvious", or the provider's experience may enable him or her to recognize the condition quickly. Theoretically, a certain pattern of signs or symptoms can be directly associated with a certain therapy, even without a definite decision regarding what is the actual disease, but such a compromise carries a substantial risk of missing a diagnosis which actually has a different therapy so it may be limited to cases where no diagnosis can be made.
Diagnostic criteria
The term diagnostic criteria designates the specific combination of signs, symptomSymptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s, and test results that the clinician uses to attempt to determine the correct diagnosis.
Some examples of diagnostic criteria are:
- Amsterdam criteriaAmsterdam criteriaThe Amsterdam criteria are a set of diagnostic criteria used by doctors to help identify families which are likely to have Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer ....
for hereditary nonpolyposis colorectal cancerHereditary nonpolyposis colorectal cancerLynch syndrome is an autosomal dominant genetic condition which has a high risk of colon cancer as well as other cancers including endometrium, ovary, stomach, small intestine, hepatobiliary tract, upper urinary tract, brain, and skin... - McDonald criteriaMcDonald criteriaThe McDonald criteria are diagnostic criteria for multiple sclerosis . These criteria are named after neurologist W. Ian McDonald. In April 2001 an international panel in association with the National Multiple Sclerosis Society of America recommended revised diagnostic criteria for MS...
for multiple sclerosisMultiple sclerosisMultiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms... - ACR criteria for systemic lupus erythematosis
Clinical decision support system
Clinical decision support systemClinical decision support system
Clinical decision support system is an interactive decision support system Computer Software, which is designed to assist physicians and other health professionals with decision making tasks, as determining diagnosis of patient data. A working definition has been proposed by Dr...
s are interactive computer programs designed to assist health professionals with decision-making tasks. The clinician interacts with the software utilizing both the clinician’s knowledge and the software to make a better analysis of the patients data than either human or software could make on their own. Typically the system makes suggestions for the clinician to look through and the clinician picks useful information and removes erroneous suggestions.
Other diagnostic procedure methods
Other methods that can be used in performing a diagnostic procedure include:- Usage of medical algorithmMedical algorithmA medical algorithm is any computation, formula, statistical survey, nomogram, or look-up table, useful in healthcare. Medical algorithms include decision tree approaches to healthcare treatment and also less clear-cut tools aimed at reducing or defining uncertainty.-Scope:Medical algorithms are...
s - An "exhaustive method", in which every possible question is asked and all possible data is collected.
Diagnostic opinion and its effects
Once a diagnostic opinion has been reached, the provider is able to propose a management plan, which will include treatment as well as plans for follow-up. From this point on, in addition to treating the patient's condition, the provider can educate the patient about the etiologyEtiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
, progression, prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...
, other outcomes, and possible treatments of her or his ailments, as well as providing advice for maintaining health.
A treatment plan is proposed which may include therapy and follow-up consultations and tests to monitor
Monitoring (medicine)
In medicine, monitoring is the evaluation of a disease or condition over time.It can be performed by continuously measuring certain parameters , and/or by repeatedly performing medical tests .Transmitting data from a monitor to a distant...
the condition and the progress of the treatment, if needed, usually according to the medical guidelines provided by the medical field on the treatment of the particular illness.
Relevant information should be added to the medical record
Medical record
The terms medical record, health record, and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdiction....
of the patient.
A failure to respond to treatments that would normally work may indicate a need for review of the diagnosis.
Additional types of diagnosis
Sub-types of diagnoses include:Clinical diagnosis
- A diagnosis made on the basis of medical signMedical signA medical sign is an objective indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....
s and patient-reported symptomSymptomA symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s, rather than diagnostic tests
Laboratory diagnosis
- A diagnosis based significantly on laboratory reports or test results, rather than the physical examinationPhysical examinationPhysical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient...
of the patient. For instance, a proper diagnosis of infectious diseases usually requires both an examination of signs and symptoms, as well as laboratory characteristics of the pathogen involved.
Radiology diagnosis
- A diagnosis based primarily on the results from medical imagingMedical imagingMedical imaging is the technique and process used to create images of the human body for clinical purposes or medical science...
studies. Greenstick fractureGreenstick fractureA greenstick, buckle or torus fracture is a fracture in a young, soft bone in which the bone bends and partially breaks. A person's bones become harder and more brittle with age. Greenstick fractures usually occur most often during infancy and childhood when bones are soft...
s are common radiological diagnoses.
Principal diagnosis
- The single medical diagnosis that is most relevant to the patient's chief complaintChief complaintThe Chief Complaint formally known as CC in the medical field, or termed Presenting Complaint in the UK, is a concise statement describing the symptom, problem, condition, diagnosis, physician recommended return, or other factor that is the reason for a medicalencounter...
or need for treatment. Many patients have additional diagnoses.
Admitting diagnosis
- The diagnosis given as the reason why the patient was admitted to the hospital; it may differ from the actual problem or from the discharge diagnoses, which are the diagnoses recorded when the patient is discharged from the hospital.
Differential diagnosis
Differential diagnosis
A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...
- A process of identifying all of the possible diagnoses that could be connected to the signs, symptoms, and lab findings, and then ruling out diagnoses until a final determination can be made.
Diagnostic criteria
- Designates the combination of signs, symptomSymptomA symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s, and test results that the clinician uses to attempt to determine the correct diagnosis. They are standards, normally published by international committees, and they are designed to offer the best sensitivity and specificitySensitivity and specificitySensitivity and specificity are statistical measures of the performance of a binary classification test, also known in statistics as classification function. Sensitivity measures the proportion of actual positives which are correctly identified as such Sensitivity and specificity are statistical...
possible, respect the presence of a condition, with the state-of-the-art technology.
Prenatal diagnosis
Prenatal diagnosis
Prenatal diagnosis or prenatal screening is testing for diseases or conditions in a fetus or embryo before it is born. The aim is to detect birth defects such as neural tube defects, Down syndrome, chromosome abnormalities, genetic diseases and other conditions, such as spina bifida, cleft palate,...
- Diagnosis work done before birth
Diagnosis of exclusion
Diagnosis of exclusion
A diagnosis of exclusion is a medical condition reached by a process of elimination, which may be necessary if presence cannot be established with complete confidence from examination or testing...
- A medical condition whose presence cannot be established with complete confidence from either examination or testing. Diagnosis is therefore by elimination of all other reasonable possibilities.
Dual diagnosis
Dual diagnosis
The term dual diagnosis is used to describe the comorbid condition of a person considered to be suffering from a mental illness and a substance abuse problem. There is considerable debate surrounding the appropriateness of the term being used to describe a heterogeneous group of individuals with...
- The diagnosis of two related, but separate, medical conditions or co-morbidities; the term almost always refers to a diagnosis of a serious mental illness and a substance addiction.
Self-diagnosis
- The diagnosis or identification of a medical conditions in oneself. Self-diagnosis is very common and typically accurate for everyday conditions, such as headacheHeadacheA headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...
s, menstrual cramps, and headlice.
Remote diagnosis
- A type of telemedicineTelemedicineTelemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities...
that diagnosis a patient without being physically in the same room as the patient.
Nursing diagnosis
Nursing diagnosis
A nursing diagnosis may be part of the nursing process and is a clinical judgement about individual, family, or community experiences/responses to actual or potential health problems/life processes...
- Rather than focusing on biological processes, a nursing diagnosis identifies people's responses to situations in their lives, such as a readiness to change or a willingness to accept assistance.
Computer-aided diagnosis
Computer-aided diagnosis
Computer-aided detection and computer-aided diagnosis are procedures in medicine that assist doctors in the interpretation of medical images. Imaging techniques in X-ray, MRI, and Ultrasound diagnostics yield a great deal of information, which the radiologist has to analyze and evaluate...
Overdiagnosis
Overdiagnosis
Overdiagnosis is the diagnosis of "disease" that will never cause symptoms or death during a patient's lifetime. Overdiagnosis is the least familiar side effect of testing for early forms of disease – and, arguably, the most important...
- The diagnosis of "disease" that will never cause symptoms, distress, or death during a patient's lifetime
Wastebasket diagnosis
Wastebasket diagnosis
A trashcan diagnosis or wastebasket diagnosis is a vague or fake medical or psychiatric diagnosis given to a patient or to medical records department for essentially non-medical reasons...
- A vague, or even completely fake, medical or psychiatric label given to the patient or to the medical recordMedical recordThe terms medical record, health record, and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdiction....
s department for essentially non-medical reasons, such as to reassure the patient by providing an official-sounding label, to make the provider look effective, or to obtain approval for treatment. This term is also used as a derogatory label for disputed, poorly described, overused, or questionably classified diagnoses, such as pouchitisPouchitisPouchitis is inflammation of the ileal pouch, which is created in the management of patients with ulcerative colitis, indeterminate colitis, or, rarely, other colitides....
and senility, or to dismiss diagnoses that amount to overmedicalization, such as the labeling of normal responses to physical hunger as reactive hypoglycemiaReactive hypoglycemiaReactive hypoglycemia, or postprandial hypoglycemia, is a medical term describing recurrent episodes of symptomatic hypoglycemia occurring within 4 hours after a high carbohydrate meal in people who do not have diabetes...
.
Retrospective diagnosis
Retrospective diagnosis
A retrospective diagnosis is the practice of identifying an illness in a historical figure using modern knowledge, methods and disease classifications...
- The labeling of an illness in a historical figure or specific historical event using modern knowledge, methods and disease classifications.
Overdiagnosis
Overdiagnosis is the diagnosis of "disease" that will never cause symptoms or death during a patient's lifetime. It is a problem because it turns people into patients unnecessarily and because it can lead to economic waste (overutilizationOverutilization
Overutilization refers to medical services that are provided with a higher volume or cost than is appropriate. In the United States, where health care costs are the highest as a percentage of GDP, overutilization is the predominant factor in its expense...
) and treatments that may cause harm. Overdiagnosis occurs when a disease is diagnosed correctly, but the diagnosis is irrelevant. A correct diagnosis may be irrelevant because treatment for the disease is not available, not needed, or not wanted.
Errors in diagnosis
Causes and factors of error in diagnosis are:- the manifestation of disease are not sufficiently noticeable
- a disease is omitted from consideration
- too much significance is given to some aspect of the diagnosis
- the condition is a rare diseaseRare diseaseA rare disease, also referred to as an orphan disease, is any disease that affects a small percentage of the population.Most rare diseases are genetic, and thus are present throughout the person's entire life, even if symptoms do not immediately appear...
with symptoms suggestive of many other conditions - the condition has a rare presentation
Lag time
When making a medical diagnosis, a lag time is a delay in time until a step towards diagnosisDiagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
of a disease or condition is made. Types of lag times are mainly:
- Onset-to-medical encounter lag time, the time from onset of symptomSymptomA symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s until visiting a health care providerHealth care providerA health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities.... - Encounter-to-diagnosis lag time, the time from first medical encounter to diagnosis
History
The history of medical diagnosis began in earnest from the days of ImhotepImhotep
Imhotep , fl. 27th century BC was an Egyptian polymath, who served under the Third Dynasty king Djoser as chancellor to the pharaoh and high priest of the sun god Ra at Heliopolis...
in ancient Egypt
Ancient Egypt
Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...
and Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...
in ancient Greece
Ancient Greece
Ancient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...
. In Traditional Chinese Medicine, there are four diagnostic methods: inspection, auscultation-olfaction, interrogation, and palpation. A Babylonia
Babylonia
Babylonia was an ancient cultural region in central-southern Mesopotamia , with Babylon as its capital. Babylonia emerged as a major power when Hammurabi Babylonia was an ancient cultural region in central-southern Mesopotamia (present-day Iraq), with Babylon as its capital. Babylonia emerged as...
n medical textbook, the Diagnostic Handbook written by Esagil-kin-apli (fl.
Floruit
Floruit , abbreviated fl. , is a Latin verb meaning "flourished", denoting the period of time during which something was active...
1069-1046 BC), introduced the use of empiricism
Empiricism
Empiricism is a theory of knowledge that asserts that knowledge comes only or primarily via sensory experience. One of several views of epistemology, the study of human knowledge, along with rationalism, idealism and historicism, empiricism emphasizes the role of experience and evidence,...
, logic
Logic
In philosophy, Logic is the formal systematic study of the principles of valid inference and correct reasoning. Logic is used in most intellectual activities, but is studied primarily in the disciplines of philosophy, mathematics, semantics, and computer science...
and rationality
Rationality
In philosophy, rationality is the exercise of reason. It is the manner in which people derive conclusions when considering things deliberately. It also refers to the conformity of one's beliefs with one's reasons for belief, or with one's actions with one's reasons for action...
in the diagnosis of an illness or disease. The book made use of logical rules in combining observed symptoms on the body of a patient with its diagnosis and prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...
. Esagil-kin-apli described the symptoms for many varieties of epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
and related ailments along with their diagnosis and prognosis.
The practice of diagnosis continues to be dominated by theories set down in the early 20th century.
See also
- Diagnosis codesDiagnosis codesIn healthcare, diagnostic codes are used to group and identify diseases, disorders, symptoms, human response patterns, and medical signs, and are used to measure morbidity and mortality...
- Diagnosis-related groupDiagnosis-related groupDiagnosis-related group is a system to classify hospital cases into one of originally 467 groups. The 467th was "Ungroupable." The system of classification was developed as a collaborative project by Robert B Fetter, PhD of the Yale School of Management, and John D Thompson, MPH of the Yale...
- Diagnostic and Statistical Manual of Mental DisordersDiagnostic and Statistical Manual of Mental DisordersThe Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
- Doctor-patient relationship
- EtiologyEtiologyEtiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
- International Statistical Classification of
Diseases and Related Health Problems (ICD)ICDThe International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...
- Medical classificationMedical classificationMedical classification, or medical coding, is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers...
- Merck Manual of Diagnosis and TherapyMerck Manual of Diagnosis and TherapyThe Merck Manual of Diagnosis and Therapy, often called simply The Merck Manual, is the world's best-selling medical textbook. First published in 1899, it is now in its 19th edition.-Professional Edition:...
- Misdiagnosis and medical errorMedical errorA medical error may be defined as a preventable adverse effect of care, whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior, infection, or other ailment.-Definitions:As a general...
- Nosology
- PathogenesisPathogenesisThe pathogenesis of a disease is the mechanism by which the disease is caused. The term can also be used to describe the origin and development of the disease and whether it is acute, chronic or recurrent...
- PathologyPathologyPathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
- Preimplantation genetic diagnosisPreimplantation genetic diagnosisIn medicine and genetics pre-implantation genetic diagnosis refers to procedures that are performed on embryos prior to implantation, sometimes even on oocytes prior to fertilization. PGD is considered another way to prenatal diagnosis...
Lists
:Category:Diseases