Accurate diagnosis is the foundation of medical practice, but at the start of the diagnostic process, uncertainty is inevitable. The clinician's skills and cognitive attributes determine the quality of the initial differential diagnosis and thus the crucial first phases of investigation and treatment; mistakes are often self-propagating. Diagnostic error is a major cause of avoidable morbidity and mortality, and is the commonest reason for successful litigation. Risk and Reasoning in Clinical Diagnosis is an accessible and readable look at the diagnostic process. Dr. Cym Ryle presents the insights and concepts developed in cognitive psychology which have led to the consensus that in all domains human reasoning is primarily driven by unconscious, intuitive mechanisms; the contribution of structured, analytical thinking is variable and inconsistent. He notes that the risk of error is inseparable from these mechanisms. Dr. Ryle then develops a description of the diagnostic process which encompasses its form, strengths and fallibility, and illustrates this description with examples from his work as a general practitioner. He argues that improving diagnostic accuracy should be a priority, and that there is sufficient evidence to guide changes in medical training, in clinical practice, and in the culture and organisation of our institutions. He identifies specific, practical steps that can be taken by individual clinicians and by clinical teams, suggests priorities for action in our institutions, and considers the obstacles to progress.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

Technology assessment can lead to the rapid application of essential diagnostic technologies and prevent the wide diffusion of marginally useful methods. In both of these ways, it can increase quality of care and decrease the cost of health care. This comprehensive monograph carefully explores methods of and barriers to diagnostic technology assessment and describes both the rationale and the guidelines for meaningful evaluation. While proposing a multi-institutional approach, it emphasizes some of the problems involved and defines a mechanism for improving the evaluation and use of medical technology and essential resources needed to enhance patient care.

This handbook describes the diagnostic process clearly and logically, aiding medical students and others who wish to improve their diagnostic performance and to learn more about the diagnostic process.

Every day we make decisions about our health - some big and some small. What we eat, how we live and even where we live can affect our health. But how can we be sure that the advice we are given about these important matters is right for us? This book will provide you with the right tools for assessing health advice.

Praise for the First Edition: “Developing a comprehensive differential diagnosis for a specific complaint is a daunting task even for experienced advanced practice nurses. This user-friendly clinical guide provides a strategy and standard format for working through this complex task. It is a wonderful tool for both students and new advanced practice nurses...” -- 5 stars, Doody’s This easy-access clinical guide to over 70 commonly seen symptoms, written for advanced practice provider (APP) students and new practitioners, describes a step-by-step process for obtaining a reliable patient history, choosing the appropriate physical exam, and using the patient history and physical exam findings to form a differential diagnosis. The second edition continues to include the case study approach, and is updated to incorporate 22 new symptoms along with contributions by a new editor, who is a leader in holistic health. The guide is distinguished by several unique features including focused patient history questions and responses, Physical Exam Findings, a Differential Diagnosis Table (clearly comparing potential diagnostic choices based on symptoms), a Diagnostic Examination table (including estimated costs and codes), and a Case Study Summary highlighting the critical thinking process. Symptoms are presented alphabetically in a systematic, unfolding case study approach and include chief complaint, presenting history, past history, and explicit methodology for determining correct diagnosis. Key Features: Describes over 70 (22 new to the second edition) commonly presented symptoms with unfolding case scenarios Offers a step-by-step approach to building clinical decision-making skills Provides quick access to differential diagnosis, requisite diagnostic tests, and clinical-decision making Guides APP students and novice practitioners in conducting a problem-focused history and examination Includes unique Differential Diagnosis tables and Diagnostic Examinations tables that help clarify strategies for diagnostic decision making