Solving the Diagnostic Challenge: A Patient-Centered Approach
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TLDR
New evidence is discussed about how patients and clinicians collaborate in specific ways, in particular, via a process that can be termed inductive foraging, which may lead to information that triggers a diagnostic routine.Abstract:
Arriving at an agreed-on and valid explanation for a clinical problem is important to patients as well as to clinicians. Current theories of how clinicians arrive at diagnoses, such as the threshold approach and the hypothetico-deductive model, do not accurately describe the diagnostic process in general practice. The problem space in general practice is so large and the prior probability of each disease being present is so small that it is not realistic to limit the diagnostic process to testing specific diagnoses on the clinician's list of possibilities. Here, new evidence is discussed about how patients and clinicians collaborate in specific ways, in particular, via a process that can be termed inductive foraging, which may lead to information that triggers a diagnostic routine. Navigating the diagnostic challenge and using patient-centered consulting are not separate tasks but rather synergistic.read more
Citations
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Lupus or not? SLE Risk Probability Index (SLERPI): a simple, clinician-friendly machine learning-based model to assist the diagnosis of systemic lupus erythematosus.
Christina Adamichou,Irini Genitsaridi,Dionysis Nikolopoulos,Myrto Nikoloudaki,Argyro Repa,Alessandra Bortoluzzi,Antonis Fanouriakis,Prodromos Sidiropoulos,Dimitrios T. Boumpas,George Bertsias +9 more
TL;DR: In this paper, the authors applied machine learning in well-characterised patient data sets to develop an algorithm that can aid systemic lupus erythematosus (SLE) diagnosis.
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Opening the black box of machine learning in radiology: can the proximity of annotated cases be a way?
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The phenomenology of the diagnostic process: A primary-care based survey
Norbert Donner-Banzhoff,Judith Seidel,Anna Maria Sikeler,Stefan Bösner,Maria Vogelmeier,Anja Westram,Markus A. Feufel,Wolfgang Gaissmaier,Odette Wegwarth,Gerd Gigerenzer +9 more
TL;DR: Cognitive strategies used by GPs for making a diagnosis are investigated to suggest that GPs organize their search for information in a skillfully adapted way and the testing of specific disease hypotheses seems to play a lesser role than previously thought.
References
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Book
Patient-Centered Medicine: Transforming the Clinical Method
Moira Stewart,Judith Belle Brown,W. Wayne Weston,Ian R. McWhinney,Carol L. McWilliam,Thomas R. Freeman +5 more
TL;DR: In this paper, the authors describe the four components of the patient-centered clinical method: exploring health, disease and the illness experience, understanding the whole person, finding common ground and enhancing the patientclinician relationship.
Journal ArticleDOI
The threshold approach to clinical decision making.
TL;DR: Using the concepts of decision analysis, expressions for two threshold probabilities involved in the choice of whether to withhold treatment, obtain more data by testing, or treat without subjecting the patient to the risks of further diagnostic tests are derived.