Wakabayashi Hidetaka, Maeda Keisuke, Momosaki Ryo, Kokura Yoji, Yoshimura Yoshihiro, Fujiwara Dai, Kosaka Shintaro, Suzuki Norio
Department of Rehabilitation Medicine Tokyo Women's Medical University Hospital Tokyo Japan.
Department of Geriatric Medicine National Center for Geriatrics and Gerontology Obu Japan.
J Gen Fam Med. 2022 Apr 28;23(4):205-216. doi: 10.1002/jgf2.549. eCollection 2022 Jul.
Diagnostic reasoning is the thought process used to arrive at a diagnosis based on symptoms, examination findings, and laboratory values. Diagnosis is categorized as nonanalytic reasoning (intuition) and analytic reasoning (analysis). Rehabilitation nutrition involves the diagnosis of nutritional disorders, sarcopenia, and excess or deficient nutrient intake. There is usually only one correct answer for the presence or absence of these. On the other hand, there may be no single correct answer for the causes of anorexia, weight loss, or sarcopenia, and analytical reasoning is required. In this case, diagnostic reasoning involves hypotheses. Simply using nutritional supplements without performing diagnostic reasoning about these causes is like prescribing antipyretic analgesics to a patient with a headache without diagnosing the cause of the headache. To maximize function and quality of life in rehabilitation nutrition, it is necessary to suspect the common causes of anorexia, weight loss, and sarcopenia in all cases.
诊断推理是一种思维过程，用于根据症状、检查结果和实验室值得出诊断结论。诊断可分为非分析性推理（直觉）和分析性推理（分析）。康复营养涉及营养障碍、肌肉减少症以及营养摄入过多或不足的诊断。对于这些情况的存在与否，通常只有一个正确答案。另一方面，对于厌食、体重减轻或肌肉减少症的原因，可能没有单一的正确答案，需要进行分析性推理。在这种情况下，诊断推理涉及假设。在未对这些原因进行诊断推理的情况下单纯使用营养补充剂，就如同在未诊断出头痛原因的情况下给头痛患者开解热镇痛药一样。为了在康复营养中最大化功能和生活质量，在所有情况下都有必要怀疑厌食、体重减轻和肌肉减少症的常见原因。
