Talk:Differential diagnosis

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[edit] Differential Diagnosis Linked Pages

It'd be great to create a series of sub-pages to Differential Diagnosis : by symptom, and by sign - starting with some of the most common and important symptoms (and signs).

For example, a page called : "Differential Diagnosis : Chest Pain" or "Differential Diagnosis : Dyspnea".

The user could also enter synonyms like "Shortness of Breath" or "Difficulty breathing" and be directed to the "Differential Diagnosis : Dyspnea" page. This would be very handy for anyone who wanted to learn more about her/his symptoms and signs. It'd also be a useful teaching tool for anyone in the healthsciences, doctors, nurses, etc.

Differential diagnoses pages would ideally have some kind of standard format. One would (ideally) want to highlight several things about the DD including :

      (1)  (very rough) Frequency - e.g. :  Common, Unusual or Rare.
      (2)  Urgency - e.g. : Emergency, Urgent (days), Urgent(weeks), Months or more.
      (3)  Importance :  High, moderate, low.  
      (4)  (very rough) Prognosis :  Bad, Ok with rapid treatment, OK, 
           good with rapid treatment, good.

One would also like to have some sense of the Mechanism for each alternative. Although these could be put on Linked pages for each disorder, it'd be best to have a sentence or two summarizing the mechanism. (Remember the " VITAMIN C DIP " mnemonic...) One would want to have (a potentially searchable) listing of the general System involved. (Ex : Lungs, Heart, etc).

Most of the data and references for this are readily available in various medical textbooks (including books on differential diagnosis), and/or online by doing a google or other web search on "Differential diagnosis of <Whatever you're looking for>". Many folks also have generated their own differential diagnoses lists as an exercise during there studies (and/or during their practice).

Having a good set of wikipedia pages on this would be very helpful however. This is particularly the case if it could be put in a concise and (somewhat) standard format.

                                   129.78.64.100 19:50, 24 February 2007 (UTC) G. Holt

Take a look at these wikipedia pages ! :

http://en.wikipedia.org/wiki/List_of_medical_symptoms

http://en.wikipedia.org/wiki/Medical_sign

Much of the core data for this project is already on wikipedia, so the key is to create a readily searchable and reasonably standardized set of differential diagnosis pages.

(Ideally, evenutally, one could create a capability to "AND" two or more signs &/or symptoms together resulting in a list of "Differential diagnoses" that contained BOTH of the signs &/or symptoms entered by the user). (One could automatically generate pages for all combinations of two, although it'd probably be better as a general search feature. Eg. Wikipedia could return *LINKS* on wiki-pages that contain BOTH). This is of secondary importance however, since the initial pages are more key.

[edit] Changes and Corrections

Note the end of the method paragraph reads: A lack of improvement during prescribed therapy for the working diagnosis necessitates reassessment.

and the sentence you put back in reads: The lack of improvement during prescribed therapy for the working diagnosis necessitates reassessment, especially when this therapy has been empirical.

In my previous version I deleted the repeated sentence and you reversed it for some reason.

On another note I'm not sure that it matters if the therapy can be emprically tested, if it is not working it is cause enough to recheck the diagnosis.

It certainly matters. Frequently, there are various diseases that can explain certain symptoms. In many cases, doctors only worry about "the rest" after treatment for the most common one is ineffective. E.g. acid reflux that does not respond to proton pump inhibitors above 50 is an indication for gastroscopy. JFW | T@lk 22:53, 2 May 2005 (UTC)

I deleted the bit about "incontrovertible proof" for now. I agree with both of you... The article needs to be clearer all-around as to when doctors declare (diagnostic) victory and start treatment. The doctor is never shooting for 100% certainty, or even some fixed level (97.5% or whatever) of certainty; it has to do with whether more tests are warranted (itself a rabbit hole), the risk of delaying treatment, the risk of treatment (in case the diagnosis is wrong), and so on. And certainly if the patient doesn't respond to treatment, the doctor is going to at least consider both "hmm, well, the reasons it might not respond are X Y Z" and "hmm, maybe it's something else". Jorend 00:27, 7 January 2006 (UTC)