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关于鉴别诊断的高阶思维。

Higher order thinking about differential diagnosis.

机构信息

Division of Physical Therapy, Duke Clinical Research Institute, Duke University, Durham, NC, United States.

Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Faculty of Medicine, Québec, Canada.

出版信息

Braz J Phys Ther. 2020 Jan-Feb;24(1):1-7. doi: 10.1016/j.bjpt.2019.01.010. Epub 2019 Jan 30.

Abstract

BACKGROUND

Differential diagnosis is a systematic process used to identify the proper diagnosis from a set of possible competing diagnoses.

METHODS

The goal of this masterclass is to discuss the higher order thinking components of differential diagnosis.

CONCLUSIONS

For healthcare providers, diagnosis is one of many necessary components during the clinical decision making process and it is hallmarked by differentiation of competing structures for a definitive understanding of the underlying condition. The diagnostic process involves identifying or determining the etiology of a disease or condition through evaluation of patient history, physical examination, and review of laboratory data or diagnostic imaging; and the subsequent descriptive title of that finding. Whereas differential diagnosis is a varied skill set among all healthcare providers, the concept of a diagnosis is equally germane, regardless of one's background. In theory, a diagnosis improves the use of classification tools, improves clarity and communication, provides a trajectory of treatment, improves understanding of a person's prognosis, and in some cases, may be useful for preventative treatments. To achieve these improvements, one must have an understanding of relation of the clinical utility of tests and measures with diagnosis, and how to best implement these findings in clinical practice. This requires a deeper understanding (higher order thinking) of the role of diagnosis in the management of patients.

摘要

背景

鉴别诊断是一种系统的过程,用于从一组可能的竞争诊断中确定正确的诊断。

方法

本次大师班的目标是讨论鉴别诊断的高级思维组成部分。

结论

对于医疗保健提供者来说,诊断是临床决策过程中的许多必要组成部分之一,其特点是对竞争结构进行区分,以明确了解潜在病情。诊断过程包括通过评估患者病史、体格检查以及查看实验室数据或诊断影像,来识别或确定疾病或病症的病因;并对该发现进行后续描述性标题。虽然鉴别诊断是所有医疗保健提供者的一项多样化技能,但诊断的概念同样重要,无论其背景如何。从理论上讲,诊断可以提高分类工具的使用效果,提高清晰度和沟通效果,提供治疗方案,加深对患者预后的理解,在某些情况下,还可能对预防治疗有用。要实现这些改进,必须了解测试和措施的临床应用与诊断之间的关系,以及如何在临床实践中最佳地应用这些发现。这需要更深入地理解(高阶思维)诊断在患者管理中的作用。

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