Given the objective of this site – namely to approach the evaluation of patients in a systematic fashion – I thought it would be useful to put some thought into how best to develop these systems. The method I’ll detail below might be cumbersome to apply in every situation, but (at this point at least) it is the best way to ensure that nothing is overlooked.
A System for Differential Diagnosis:
Any illness or abnormality for which a patient could seek medical attention (or a colleague, consultation) can be broadly encompassed by the statement above. The differential diagnosis is developed by delineating the chief concern(s) or primary aberrant signs, and selecting a relevant mixture of disease processes and organ systems. The differential can be narrowed by determining subjective and objective details surrounding the chief concern. The differential can be broadened by expanding each major category into subcategories.
References:
- Benbassat, J., & Bachar-Bassan, E. (1984). A comparison of initial diagnostic hypotheses of medical students and internists. Journal of medical education, 59(12), 951–956.
- Bowen, J. L. (2006). Educational strategies to promote clinical diagnostic reasoning. The New England journal of medicine, 355(21), 2217–2225. doi:10.1056/NEJMra054782
- Coderre, S., Mandin, H., Harasym, P. H., & Fick, G. H. (2003). Diagnostic reasoning strategies and diagnostic success. Medical education, 37(8), 695–703.
- Fulop, M. (1985). Teaching differential diagnosis to beginning clinical students. The American journal of medicine, 79(6), 745–749.
- Graber, M. L., Tompkins, D., & Holland, J. J. (2009). Resources medical students use to derive a differential diagnosis. Medical teacher, 31(6), 522–527.
- Sapira, J. D. (1981). Diagnostic strategies. Southern medical journal, 74(5), 582–584.