paf reading program first steps workbook

Once a patient seeks health care, there is an iterative process of information gathering, information integration and interpretation, and determining a working diagnosis.

The patient is likely the first person to consider his or her symptoms and may choose at this point to engage with the health care system. The diagnostic process proceeds as follows: First, a patient experiences a health problem. To help manage this complexity, the chapter concludes with a discussion of the role of clinical practice guidelines in informing decision making in the diagnostic process. The rising complexity of health care and the sheer volume of advances, coupled with clinician time constraints and cognitive limitations, have outstripped human capacity to apply this new knowledge. It also highlights the mounting complexity of health care, due to the ever-increasing options for diagnostic testing 2 and treatment, the rapidly rising levels of biomedical and clinical evidence to inform clinical practice, and the frequent comorbidities among patients due to the aging of the population ( IOM, 2008, 2013b). The chapter describes important considerations in the diagnostic process, such as the roles of diagnostic uncertainty and time. In addition, public policy decisions are often influenced by diagnostic information, such as setting payment policies, resource allocation decisions, and research priorities ( Jutel, 2009 Rosenberg, 2002 WHO, 2012). 1 When a diagnosis is accurate and made in a timely manner, a patient has the best opportunity for a positive health outcome because clinical decision making will be tailored to a correct understanding of the patient's health problem ( Holmboe and Durning, 2014). Diagnosis has been described as both a process and a classification scheme, or a “pre-existing set of categories agreed upon by the medical profession to designate a specific condition” ( Jutel, 2009). Diagnosis has important implications for patient care, research, and policy. This chapter provides an overview of diagnosis in health care, including the committee's conceptual model of the diagnostic process and a review of clinical reasoning.

Paf reading program first steps workbook