Diagnostic Reasoning Beginnings
Terms
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- Hypothesis
- Generate___________ early, and competeting. Address life threateneing and functional threats. Consider zebras.
- Symptoms in Hypothesis Testing
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Symptoms in same organ system are likely to be related.
Those in two different systems may be two different diseases, a single multisystem disease, ir a diffuse spread of single disease.
Clinical picture of one disease may be altered by the presence of another disease. - Sensitivity
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Positive in disease. PID.
Think Pelvic Inflamatory Disease.
Proportion of patients with the diagnosis who have the assessment finding (positive result). Highly sensitive tests are best to rule out diagnosis. - Specificity
- Negative in Health. NIH. Think National Instutite of Health. Proprotion of patients with out the diagnoisis who Do Not Have the findinding. (Negative result). High specificity best for confirming diagnosis, rearely positive in absence of disease.
- The greater the abnormality of the test...
- the more likely it is to be significant.
- During Data Acquisition it is important to
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use a systematic approach.
Be accurate & comprehensive.
Distinguish between relevant and irrelevant data. Consider sensitivity & specificity.
screen and branch. - The Phases in Diagnostic Reasoning are:
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Data Acquisition
Hypothesis formation
Hypothesis evaluation
Problem naming
Goal setting
Therapeutic plan
Evaluation - SpPin
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A specific test when positive rules IN the disease.
Sp (specific) P (positive) in (rules in) - SnNout
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A sensitive test when negative rules OUT the disease.
Sn (Sensitivity) N (Negative) out (rules out) - Highly _____________ tests are best to rule out diagnosis.
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Sensitive
Because absence of sensitive finding greatley decreases probabilty of disease - Highly__________ tests are best to rule in diagnosis
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Specific
Because the presence of a finding with high specificity greatly increases the probablity of a disease - When data does not support a specific diagnosis you should summarize the__________ and or____________.
- Signs and or Symptoms
- Insufficient data, overemphasizing cues for favorite hypothesis and ignoring data that disproves a hypothesis are all examples of_________________.
- Errors in Diagnostic Reasoning.
- Symptom Analysis includes:
- onset, location, duration, characteristics, aggrivating, alleviating, response to treatment (what they have tried)