Winkler P
Dtsch Med Wochenschr. 1979 Sep 14;104(37):1301-6. doi: 10.1055/s-0028-1129088.
In a prospective study of 100 inpatients, "history-taking diagnosis" was analysed in terms of proven probability sequence, on the basis of an extensive history-taking plan. The most likely diagnosis, as obtained by history-taking, was the same as that in the final discharge letter in 72% of cases. In only 5% did new investigations establish a diagnosis not made by history-taking. Physical examination, radiological and laboratory tests, in some cases also special investigations such as renal biopsy, proved of importance, in the first instance in establishing the diagnosis (adding to or confirming diagnostic criteria) and the choice of diagnosis (exclusion diagnosis). It is a prerequisite for a high percentage of correct diagnoses by history-taking that the examining doctor is familiar with the clinical picture of rheumatic diseases, including their epidemiology, age and sex distribution, organ involvement and pattern of joint involvement, and takes time in obtaining a good history.
在一项针对100名住院患者的前瞻性研究中，根据详尽的病史采集计划，从确诊概率顺序方面对“病史采集诊断”进行了分析。通过病史采集得出的最可能诊断与最终出院小结中的诊断相同的病例占72%。只有5%的病例通过新的检查确定了病史采集未做出的诊断。体格检查、放射学和实验室检查，在某些情况下还有诸如肾活检等特殊检查，首先在确立诊断（补充或确认诊断标准）和诊断选择（排除诊断）方面证明是重要的。要通过病史采集获得高比例的正确诊断，检查医生熟悉风湿性疾病的临床表现，包括其流行病学、年龄和性别分布、器官受累情况和关节受累模式，并花时间获取详尽病史，这是一个先决条件。
