Improving Diagnosis in Health Care


Book Description

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.




Diagnosis


Book Description

A collection of more than fifty hard-to-crack medical quandaries, featuring the best of The New York Times Magazine's popular Diagnosis column—now a Netflix original series “Lisa Sanders is a paragon of the modern medical detective storyteller.”—Atul Gawande, author of Being Mortal As a Yale School of Medicine physician, the New York Times bestselling author of Every Patient Tells a Story, and an inspiration and adviser for the hit Fox TV drama House, M.D., Lisa Sanders has seen it all. And yet she is often confounded by the cases she describes in her column: unexpected collections of symptoms that she and other physicians struggle to diagnose. A twenty-eight-year-old man, vacationing in the Bahamas for his birthday, tries some barracuda for dinner. Hours later, he collapses on the dance floor with crippling stomach pains. A middle-aged woman returns to her doctor, after visiting two days earlier with a mild rash on the back of her hands. Now the rash has turned purple and has spread across her entire body in whiplike streaks. A young elephant trainer in a traveling circus, once head-butted by a rogue zebra, is suddenly beset with splitting headaches, as if someone were “slamming a door inside his head.” In each of these cases, the path to diagnosis—and treatment—is winding, sometimes frustratingly unclear. Dr. Sanders shows how making the right diagnosis requires expertise, painstaking procedure, and sometimes a little luck. Intricate, gripping, and full of twists and turns, Diagnosis puts readers in the doctor’s place. It lets them see what doctors see, feel the uncertainty they feel—and experience the thrill when the puzzle is finally solved.




Symptom to Diagnosis


Book Description

This innovative introduction to patient encounters utilizes an evidence-based step-by-step process that teaches students how to evaluate, diagnose, and treat patients based on the clinical complaints they present. By applying this approach, students are able to make appropriate judgments about specific diseases and prescribe the most effective therapy. (Product description).




Symptom to Diagnosis An Evidence Based Guide, Fourth Edition


Book Description

"This book is a tremendous asset for students and residents learning to develop their diagnostic skills. It can also be useful as a refresher for established clinicians when the more common diagnoses are not the cause of a patient's complaints." —Doody's Review An engaging case-based approach to learning the diagnostic process in internal medicine Doody's Core Titles for 2023! Symptom to Diagnosis, Fourth Edition teaches an evidence-based, step-by-step process for evaluating, diagnosing, and treating patients based on their clinical complaints. By applying this process clinicians will be able to recognize specific diseases and prescribe the most effective therapy. Each chapter is built around a common patient complaint that illustrates essential concepts and provides insight into the process by which the differential diagnosis is identified. As the case progresses, clinical reasoning is explained in detail. The differential diagnosis for that particular case is summarized in tables that highlight the clinical clues and important tests for the leading diagnostic hypothesis and alternative diagnostic hypotheses. As the chapter progresses, the pertinent diseases are reviewed. Just as in real life, the case unfolds in a stepwise fashion as tests are performed and diagnoses are confirmed or refuted. Completely updated to reflect the latest research in clinical medicine, this fourth edition is enhanced by algorithms, summary tables, questions that direct evaluation, and an examination of recently developed diagnostic tools and guidelines. Clinical pearls are featured in every chapter. Coverage for each disease includes: Textbook Presentation, Disease Highlights, Evidence-Based Diagnosis, and Treatment.




Small Animal Medical Differential Diagnosis


Book Description

Small Animal Medical Differential Diagnosis, 2nd Edition is a practical, concise guide to the differential diagnosis, etiology, laboratory abnormalities, and classification of clinical signs and medical disorders in dogs and cats. By covering nearly every possible sign and clinical disorder relevant to small animal medical practice, this pocket-sized, rapid reference helps you make more reliable on-the-scene decisions. More than 400 lists bring the most important medical diagnostic information from multiple resources into a single rapid reference. An organized presentation of differential diagnoses by sign and symptom, disorder, and body system, facilitates quick and flexible access to information at many stages of the diagnostic work-up. Alphabetical listing of all relevant laboratory tests makes information easy to find for students and experienced practitioners alike. Easily identify the likeliest diagnosis by reviewing the possibilities listed in order of incidence. Pocket-sized for portability, practicality, and quick reference. NEW! Coverage of new disorders and syndromes expands the span of differential diagnoses to help you effectively evaluate more signs and symptoms. NEW! Addition of new and more widely used diagnostic and laboratory tests keeps you up-to-date as lab tests become more specialized and sophisticated.




Oxford Handbook of Clinical Diagnosis


Book Description

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.




Evidence-based Physical Diagnosis


Book Description

Clinical reference that takes an evidence-based approach to the physical examination. Updated to reflect the latest advances in the science of physical examination, and expanded to include many new topics.




Overdiagnosed


Book Description

An exposé on Big Pharma and the American healthcare system’s zeal for excessive medical testing, from a nationally recognized expert More screening doesn’t lead to better health—but can turn healthy people into patients. Going against the conventional wisdom reinforced by the medical establishment and Big Pharma that more screening is the best preventative medicine, Dr. Gilbert Welch builds a compelling counterargument that what we need are fewer, not more, diagnoses. Documenting the excesses of American medical practice that labels far too many of us as sick, Welch examines the social, ethical, and economic ramifications of a health-care system that unnecessarily diagnoses and treats patients, most of whom will not benefit from treatment, might be harmed by it, and would arguably be better off without screening. Drawing on 25 years of medical practice and research on the effects of medical testing, Welch explains in a straightforward, jargon-free style how the cutoffs for treating a person with “abnormal” test results have been drastically lowered just when technological advances have allowed us to see more and more “abnormalities,” many of which will pose fewer health complications than the procedures that ostensibly cure them. Citing studies that show that 10% of 2,000 healthy people were found to have had silent strokes, and that well over half of men over age sixty have traces of prostate cancer but no impairment, Welch reveals overdiagnosis to be rampant for numerous conditions and diseases, including diabetes, high cholesterol, osteoporosis, gallstones, abdominal aortic aneuryisms, blood clots, as well as skin, prostate, breast, and lung cancers. With genetic and prenatal screening now common, patients are being diagnosed not with disease but with “pre-disease” or for being at “high risk” of developing disease. Revealing the economic and medical forces that contribute to overdiagnosis, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, excessive worry, and exorbitant costs, all while maintaining a balanced view of both the potential benefits and harms of diagnosis. Drawing on data, clinical studies, and anecdotes from his own practice, Welch builds a solid, accessible case against the belief that more screening always improves health care.







Every Patient Tells a Story


Book Description

A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D. "The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it—on some level—restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer." A healthy young man suddenly loses his memory—making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment—only to have their symptoms mysteriously return. A young woman lies dying in the ICU—bleeding, jaundiced, incoherent—and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis. Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness—the diagnosis—revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.