Santhosh Lekshmi, Chou Calvin L, Connor Denise M
Assistant Professor of Clinical Medicine, Divisions of Pulmonary and Critical Care Medicine and Hospital Medicine, University of California, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
Department of Medicine, University of California, San Francisco, CA, USA.
Diagnosis (Berl). 2019 Jun 26;6(2):121-126. doi: 10.1515/dx-2018-0088.
Diagnostic uncertainty is common in clinical practice and affects both providers and patients on a daily basis. Yet, a unifying model describing uncertainty and identifying the best practices for how to teach about and discuss this issue with trainees and patients is lacking. In this paper, we explore the intersection of uncertainty and expertise. We propose a 2 × 2 model of diagnostic accuracy and certainty that can be used in discussions with trainees, outline an approach to communicating diagnostic uncertainty with patients, and advocate for teaching trainees how to hold such conversations with patients.
诊断不确定性在临床实践中很常见，并且每天都在影响着医疗服务提供者和患者。然而，目前缺乏一个统一的模型来描述不确定性，并确定如何向实习生传授以及与患者讨论这个问题的最佳实践方法。在本文中，我们探讨了不确定性与专业知识的交叉点。我们提出了一个用于与实习生讨论的诊断准确性和确定性的2×2模型，概述了与患者沟通诊断不确定性的方法，并主张教导实习生如何与患者进行此类对话。
