Medical diagnosis refers both to the process of attempting to determine the identity of a possible 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 disfunctions, such as autoimmune diseases or disorder and to the opinion reached by this process.

The term diagnostic criteria designates the combination of signs A 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, symptoms A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality. A symptom is subjective, observed by the patient, and not measured, and test results that the clinician A clinic is a small private or public health facility that is devoted to the care of outpatients, often in a community, in contrast to larger hospitals, which also treat inpatients. Some grow to be institutions as large as major hospitals, whilst retaining the name clinic. These are often associated with a hospital or medical school uses to attempt to determine the correct diagnosis. 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 Greek , an independent branch of the Indo-European family of languages, is the language of the Greeks. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. In its ancient form, it is the language of classical ancient Greek literature and the New Testament of word διάγιγνῶσκειν, meaning to discern or distinguish.^[1] This Greek word is formed from διά, meaning apart, and γιγνῶσκειν, meaning to learn.

Overview

Typically, a person with abnormal symptoms will consult a health care provider such as a physician A physician—also known as doctor of medicine, medical doctor, or simply doctor—practices the ancient profession of medicine, which is concerned with maintaining or restoring human health through the study, diagnosis, and treatment of disease or injury. This properly requires both a detailed knowledge of the academic disciplines underlying, podiatrist, nurse practitioner, physical therapist Physical therapy is a health care profession that provides treatment to individuals to develop, maintain and restore maximum movement and function throughout life. This includes providing treatment in circumstances where movement and function are threatened by aging, injury, disease or environmental factors or physicians assistant, who will then obtain a medical history The 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 (in this case, it is sometimes called heteroanamnesis), with the aim of obtaining information useful in formulating a diagnosis and providing of the patient A patient is any person who receives medical attention, care, or treatment. The person is most often ill or injured and in need of treatment by a physician or other health care professional, although one who is visiting a physician for a routine check-up may also be viewed as a patient's illness and perform a physical examination Physical 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. Together with the medical history, the physical examination aids in determining the correct for signs of disease. The provider will formulate a hypothesis of likely diagnoses and in many cases will obtain further testing to confirm or clarify the diagnosis before providing treatment.

Medical tests A medical test is a kind of medical procedure performed to detect, diagnose, or evaluate disease, disease processes, susceptibility, and determine a course of treatment commonly performed are measuring blood pressure Blood pressure is a force exerted by circulating blood on the walls of blood vessels, and is one of the principal vital signs. During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure. The mean BP, due to pumping by the heart and resistance in blood vessels, decreases as the circulating blood moves away from, checking the pulse rate In medicine, a person's pulse represents the tactile arterial palpation of the heartbeat. Sphygmology is a term from perhaps the 2nd century AD that roughly translates as "all that is known about the pulse". The pulse may be palpated in any place that allows an artery to be compressed against a bone, such as at the neck , at the wrist (, listening to the heart with a stethoscope The stethoscope is an acoustic medical device for auscultation, or listening to the internal sounds of an animal body. It is often used to listen to lung and heart sounds. It is also used to listen to intestines and blood flow in arteries and veins. In combination with a sphygmomanometer, it is commonly used for measurements of blood pressure, urine tests A urinalysis is an array of tests performed on urine and one of the most common methods of medical diagnosis. A part of a urinalysis can be performed by using urine dipsticks, in which the test results can be read as color changes, fecal tests One of the most common stool tests, the Fecal occult blood test can be used to diagnose many conditions that cause in bleeding in the gastrointestinal system including Colorectal cancer or Stomach cancer, saliva tests, blood tests 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, medical imaging Medical imaging is the technique and process used to create images of the human body for clinical purposes (medical procedures seeking to reveal, diagnose or examine disease) or medical science (including the study of normal anatomy and physiology). Although imaging of removed organs and tissues can be performed for medical reasons, such, electrocardiogram Electrocardiography is a transthoracic interpretation of the electrical activity of the heart over time captured and externally recorded by skin electrodes. It is a noninvasive recording produced by an electrocardiographic device. The etymology of the word is derived from the Greek electro, because it is related to electrical activity, cardio,, hydrogen breath test A hydrogen breath test is used as a clinical medical diagnosis for people with irritable bowel syndrome, and common food intolerances. The test is simple, non-invasive, and is performed after a short period of fasting (typically 8-12 hours). Even though the test is normally known as a "Hydrogen Breath Test" some physicians may also test and occasionally biopsy A biopsy is a medical test involving the removal of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically. When an entire lump or suspicious area is.

For instance, a common disorder such as pneumonia Pneumonia is an inflammatory condition of the lung. It is often characterized as including inflammation of the parenchyma of the lung and abnormal alveolar filling with fluid (consolidation and exudation) was nevertheless used as a diagnosis before the germ theory was accepted, and the disease was defined as a complex of many symptoms consisting of cough, sputum Sputum is matter that is expelled from the respiratory tract, such as mucus or phlegm, mixed with saliva, which can then be spat from the mouth. It is usually associated with air passages in diseased lungs, bronchi, or upper respiratory tract and also a case of pneumonia. It can be found to contain blood if in a chronic cough possibly from severe production, fever and chills. Later, as the actual cause was assigned to micro-organisms, the term diagnosis included the causality, e.g., pneumococcal pneumonia, suggesting not only a spectrum of symptoms but also a cause for the symptoms.

Advances in medicine could be described as a shift from definition #1 to definition #2 as scientific causalities were discovered. This differentiation of the term diagnosis is critically important because widespread disagreement exists between medical and psychiatric practitioners as to whether causalities for various diseases and disorders are known or not.^{[citation needed]} If causalities are assumed to be known, then authentic cures can be obtained by correcting the causal abnormalities. If causalities are assumed to be unknown, then palliative treatments to reduce symptoms are the best treatments possible.

Diagnosis in medical practice

A provider's job is to know the human body and its functions in terms of normality (homeostasis Human homeostasis refers to the body's ability to physiologically regulate its inner environment to ensure its stability in response to fluctuations in the outside environment and the weather. The liver, the kidneys, and the brain help maintain homeostasis. The liver is responsible for metabolizing toxic substances and maintaining carbohydrate). The four cornerstones of diagnostic medicine, each essential for understanding homeostasis, are: anatomy Anatomy 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 (zootomy) and plant anatomy (phytotomy). In some of its facets anatomy is closely related to embryology, comparative anatomy and comparative embryology, through common roots in (the structure of the human body), physiology Physiology is the science of the functioning of living systems. It is a subcategory of biology. In physiology, the scientific method is applied to determine how organisms, organ systems, organs, cells and biomolecules carry out the chemical or physical function that they have in a living system. The word physiology is from Ancient Greek: φύσις (how the body works), pathology In medicine, pathology is the study and diagnosis of disease. The related scientific study of disease processes is called "general pathology". Medical pathology is divided into two main branches, anatomical pathology and clinical pathology. Medical pathologists work through examination of organs, tissues, bodily fluids, and whole bodies (what can go wrong with the anatomy and physiology) and psychology Psychology is the scientific study of human or other animal mental functions and behaviors. In this field, a professional practitioner or researcher is called a psychologist. Psychologists are classified as social or behavioral scientists. Psychological research can be considered either basic or applied. Psychologists attempt to understand the (thought and behavior). Once the provider knows what is normal and can measure the patient's current condition against those norms, she or he can then determine the patient's particular departure from homeostasis and the degree of departure. This is called the diagnosis. Once a diagnosis 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 educates the patient about the causes, progression, outcomes, and possible treatments of his ailments, as well as providing advice for maintaining health.

It should be noted however, that medical diagnosis in psychology or psychiatry is problematic. Apart from the fact that there are differing theoretical views toward mental conditions and that there are few "lab" tests available for various major disorders (e.g., clinical depression Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder), 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 as well as 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)

Diagnostic procedure

The diagnostic process is fluid in which the provider gathers information from the patient and others, from a physical examination of the patient, and from medical tests performed upon the patient.

There are a number of techniques used by providers to obtain a correct diagnosis^[2]:

exhaustive method

every possible question is asked and all possible data is collected.

algorithmic method

the provider follows the steps of a proven strategy.

pattern-recognition method

the provider uses experience to recognise a pattern of clinical characteristics.

differential diagnosis A differential diagnosis is a systematic method used to identify unknowns. This method, essentially a process of elimination, is used by taxonomists to identify living organisms, and by physicians, physician assistants, and other trained medical professionals to diagnose the specific disease in a patient

the provider uses the hypothetico-deductive method The hypothetico-deductive model or method, first so-named by William Whewell, is a proposed description of scientific method. According to it, scientific inquiry proceeds by formulating a hypothesis in a form that could conceivably be falsified by a test on observable data. A test that could and does run contrary to predictions of the hypothesis, a systematic, problem-focused method of inquiry.

The advanced clinician uses a combination of the pattern-recognition and hypothetico-deductive approaches.^[3]

The presence of some medical conditions cannot be established with complete confidence from examination or testing. Diagnosis is therefore by elimination of other reasonable possibilities, referred to as the diagnosis of exclusion The term diagnosis of exclusion refers to a medical condition whose presence cannot be established with complete confidence from examination or testing. Diagnosis is therefore by elimination of other reasonable possibilities.

The provider should consider the patient in their 'well' context rather than simply as a walking medical condition. This entails assessing the socio-political context of the patient (family, work, stress, beliefs), in addition to the patient's physical body, as this often offers vital clues to the patient's condition and its management.

The process of diagnosis begins when the patient consults the provider and presents a set of complaints (symptoms). If the patient is unconscious, this condition is the de facto complaint. The provider then obtains further information from the patient and from those who know him or her, if present, about the patient's symptoms, their previous state of health, living conditions, and so forth.

Rather than consider the myriad diseases that could afflict the patient, the provider narrows down the possibilities to their illnesses likely to account for the apparent symptoms, making a list of only those disease (conditions) that could account for what is wrong with the patient. These are generally ranked in order of probability.

The provider then conducts a physical examination Physical 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. Together with the medical history, the physical examination aids in determining the correct of the patient, studies the patient's medical record A medical record, health record, or medical chart is a systematic documentation of a patient's individual medical history and care. The term 'Medical record' is used both for the physical folder for each individual patient and for the body of information which comprises the total of each patient's health history. Medical records are intensely, and asks further questions in an effort to rule out as many of the potential conditions as possible. When the list is narrowed down to a single condition, this is called the differential diagnosis A differential diagnosis is a systematic method used to identify unknowns. This method, essentially a process of elimination, is used by taxonomists to identify living organisms, and by physicians, physician assistants, and other trained medical professionals to diagnose the specific disease in a patient and provides the basis for a hypothesis of what is ailing the patient.

Unless the provider is certain of the condition present, further medical tests are performed or scheduled such as medical imaging, in part to confirm or disprove the diagnosis but also to document the patient's status to keep the patient's medical history up to date. Consultations with other providers and specialists in the field may be sought. If unexpected findings are made during this process, the initial hypothesis may be ruled out and the provider must then consider other hypotheses.

Despite all of these complexities, most patient consultations are relatively brief, because many diseases are obvious, or the providers experience may enable him or her to recognize the condition quickly. Another factor is that the decision tree A decision tree is a decision support tool that uses a tree-like graph or model of decisions and their possible consequences, including chance event outcomes, resource costs, and utility. Decision trees are commonly used in operations research, specifically in decision analysis, to help identify a strategy most likely to reach a goal. Another use is used for most diagnostic hypothesis testing are relatively short.

Once the provider has completed the diagnosis, the prognosis is explained to the patient and a treatment plan is proposed which includes therapy and follow-up consultations and tests to monitor the condition and the progress of the treatment, if needed, usually according to the medical guideline provided by the medical field on the treatment of the particular illness.

Treatment itself may indicate a need for review of the diagnosis if there is a failure to respond to treatments that would normally work.

A laboratory diagnosis is either a substitution or complement to the diagnosis made by examination of the patient. For instance, a proper diagnosis of infectious diseases usually requires both an examination of symptoms, as well as laboratory characteristics of the pathogen involved.

Diagnostic tests

A diagnostic test is any kind of medical test A medical test is a kind of medical procedure performed to detect, diagnose, or evaluate disease, disease processes, susceptibility, and determine a course of treatment performed to aid in the diagnosis or detection of disease. The possible benefits of a diagnostic test must be weighed against the costs of unnecessary tests and resulting unnecessary follow-up and possibly even unnecessary treatment of incidental findings.^[4]

Diagnostic tests can have psychological effects on the patient that increase or reduce the symptoms.^[5][6]

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 leads to treatments that can only 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 of error in diagnosis are:^[7]

• 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

Tools

Clinical decision support systems Clinical decision support systems are interactive computer programs, which are designed to assist physicians and other health professionals with decision making tasks. A working definition has been proposed by Dr. Robert Hayward of the Centre for Health Evidence; "Clinical Decision Support systems link health observations with health 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.^[8]

History

The history of medical diagnosis began in earnest from the days of Imhotep Imhotep (sometimes spelled Immutef, Im-hotep, or Ii-em-Hotep; called Imuthes by the Greeks), fl. 27th century BC (2655-2600 BC) (Egyptian ii-m-ḥtp *jā-im-ḥatāp meaning "the one who comes in peace") was an Egyptian polymath, who served under the Third Dynasty king, Djoser, as chancellor to the pharaoh and high priest of the sun god in ancient Egypt Ancient Egypt was an ancient civilization of eastern North Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. The civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh, and it developed over the next three millennia. Its history and Hippocrates Hippocrates of Cos or Hippokrates of Kos - Greek: Ἱπποκράτης; Hippokrátēs was an ancient Greek physician of the Age of Pericles (Classical Athens), and is considered one of the most outstanding figures in the history of medicine. He is referred to as the Western father of medicine in recognition of his lasting contributions to the in ancient Greece Ancient Greece is the civilization belonging to the period of Greek history lasting from the Archaic period of the 8th to 6th centuries BC to 146 BC and the Roman conquest of Greece after the Battle of Corinth. At the center of this time period is Classical Greece, which flourished during the 5th to 4th centuries BC, at first under Athenian. In Traditional Chinese Medicine, there are four diagnostic methods: inspection, auscultation-olfaction, interrogation, and palpation.^[9] A Babylonian Babylonia was an ancient cultural region in central-southern Mesopotamia , with Babylon as its capital. Babylonia emerged when Hammurabi (fl. ca. 1696 – 1654 BC, short chronology) created an empire out of the territories of the former Akkadian Empire. Babylonia adopted the written Semitic Akkadian language for official use, and retained the medical textbook, the Diagnostic Handbook written by Esagil-kin-apli (fl. Floruit is a Latin verb meaning 'flourished', which denotes the period of time during which a person, school, movement or even species was active. In English, the word is occasionally used as a noun indicating the timeframe in which someone 'flourished' 1069-1046 BC), introduced the use of empiricism In philosophy, empiricism is a theory of knowledge that asserts that knowledge arises from evidence gathered via sense experience. Empiricism is one of several competing views that predominate in the study of human knowledge, known as epistemology. Empiricism emphasizes the role of experience and evidence, especially sensory perception, in the, logic Logic is the study of reasoning. Logic is used in most intellectual activities, but is studied primarily in the disciplines of philosophy, mathematics, and computer science. Logic examines general forms which arguments may take, which forms are valid, and which are fallacies. It is one kind of critical thinking. In philosophy, the study of logic and rationality in the diagnosis of an illness or disease.^[10] The book made use of logical rules in combining observed symptoms on the body of a patient with its diagnosis and prognosis.^[11] Esagil-kin-apli described the symptoms for many varieties of epilepsy and related ailments along with their diagnosis and prognosis.^[12]

The practice of diagnosis continues to be dominated by theories set down in the early 20th century.

See also

Lists

References

1. ^ "Online Etymology Dictionary". http://www.etymonline.com/index.php?term=diagnosis.
2. ^ Making a diagnosis, John P. Langlois, Chapter 10 in Fundamentals of clinical practice (2002). Mark B. Mengel, Warren Lee Holleman, Scott A. Fields. 2nd edition. p.198. ISBN 0-306-46692-9
3. ^ p.204 ibid.
4. ^ Jarvik J, Hollingworth W, Martin B, Emerson S, Gray D, Overman S, Robinson D, Staiger T, Wessbecher F, Sullivan S, Kreuter W, Deyo R (2003). "Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial". JAMA 289 (21): 2810–8. doi:10.1001/jama.289.21.2810. PMID 12783911.
5. ^ Sox H, Margulies I, Sox C (1981). "Psychologically mediated effects of diagnostic tests". Ann Intern Med 95 (6): 680–5. PMID 7305144.
6. ^ Petrie K, Müller J, Schirmbeck F, Donkin L, Broadbent E, Ellis C, Gamble G, Rief W (2007). "Effect of providing information about normal test results on patients' reassurance: randomised controlled trial". BMJ 334: 352. doi:10.1136/bmj.39093.464190.55. PMID 17259186.
7. ^ doi:10.1207/s15516709cog0503_3
8. ^ Decision support systems. 26 July 2005. 17 Feb. 2009 <http://www.openclinical.org/dss.html>
9. ^ Four diagnostic methods of traditional Chinese medicine
10. ^ H. F. J. Horstmanshoff, Marten Stol, Cornelis Tilburg (2004), Magic and Rationality in Ancient Near Eastern and Graeco-Roman Medicine, p. 97-98, Brill Publishers, ISBN 90-04-13666-5.
11. ^ H. F. J. Horstmanshoff, Marten Stol, Cornelis Tilburg (2004), Magic and Rationality in Ancient Near Eastern and Graeco-Roman Medicine, p. 99, Brill Publishers, ISBN 90-04-13666-5.
12. ^ Marten Stol (1993), Epilepsy in Babylonia, p. 5, Brill Publishers, ISBN 90-72371-63-1.

External links

• The Merck Manuals Online Medical Library

Categories: Diagnosis classification | Medical terms | Nosology

See Also:

• Society: People: Requesting Help: Medical Needs: Directory
• Society: Philanthropy: Organizations: Medical Relief: Directory
• Society: Philanthropy: Organizations: Child Welfare: Medical: Directory
• Society: Philanthropy: Organizations: Medical Relief: Health Flights: Directory
• Society: Philanthropy: Organizations: Child Welfare: Medical: Children's Miracle Network: Directory

What Links Here:

Recently Viewed Pages:

• Home
• Purchasing Power Parity: Answers
• Asia: Blogs
• Workfare
• Indian Guide and Princesses: Blogs
• Sub-Saharan Africa: Answers
• Search Terms
• About Us
• Domain Details
• Society: Issues: Poverty: Causes: Directory

Most Popular Pages:

• Purchasing Power Parity: Answers
• Workfare
• Board of Guardians: Images
• Indian Guide and Princesses: Blogs
• Poverty Line
• Axelle Kabou: Blogs
• Society: Issues: Poverty: Welfare: Earned Income Tax Credit
• Causes
• Poverty
• Extreme Poverty: Encyclopedia

Related 'Medical Diagnosis' Searches: