Talk:Differential diagnosis

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Differential Diagnosis Linked Pages[edit]

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.


Changes and Corrections[edit]

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)

commission?[edit]

"Relying on memory instead of inference can also lead to errors of omission and commission" Could somebody please explain the meaning of commission in this case? —The preceding unsigned comment was added by Mortsggah (talkcontribs) 08:50, 6 May 2007 (UTC).

It just means what you do as opposed to what you don't do, so you can make an error by doing something wrong (commission) or by not doing something right (omission). 87.112.17.14 13:30, 28 May 2007 (UTC)

NPOV[edit]

Statements like "...one should always either generate these lists from one's knowledge and from first principles, or one should memorize large sets of differential diagnosis lists" are not acceptably neutral, especially when coupled with weasel-wording about what "purists" may "disparage" or "believe." ➥the Epopt 04:35, 27 May 2007 (UTC)

Comparison Chart?[edit]

What on Earth is this comparison chart meant for? It looks all the same, minus the links. I propose removing the table and perhaps just linking below.

FlowRate (talk) 22:27, 24 April 2008 (UTC)

I have removed the comparison chart, as nobody has argued otherwise.
FlowRate (talk) 08:21, 27 April 2008 (UTC)

External Link[edit]

I propose the reinsertion of en.diagnosispro.com and emedicine.com as relevant links under machine differential diagnosis section or external links. Please let me know what you think. —Preceding unsigned comment added by 76.240.83.110 (talk) 23:15, 15 August 2008 (UTC)

The topic is mentioned within the body of 125 other separate articles on various medical conditions[edit]

Doesn't this figure seem a little bit low? A search on Google Scholar reveals 697000 articles - I find it really hard to believe that only 125 articles use the term in the body text. 78.86.25.140 (talk) 08:06, 24 December 2008 (UTC)

I agree the entry is a bit strange. It's removed now. Mikael Häggström (talk) 14:09, 23 October 2011 (UTC)

Epidemiology method[edit]

I'm uncertain whether any better reference can currently be found than "used by physicians at Uppsala Academic Hospital" or lecture notes for the recent addition of a method of using differential diagnosis. Still, I consider it to be based rather on common sense, and should be verified as such. Mikael Häggström (talk) 16:00, 29 October 2011 (UTC)

Line breaking[edit]

I'm aware of that some of the formulas are in need of line breaking, and I've requested expertise in the matter at: Help_talk:Displaying_a_formula#Help_with_line_breaking.2C_please. Mikael Häggström (talk) 16:01, 29 October 2011 (UTC)

These are fairly simple probability equations that can be made more readable if we replace things like "Patient with condition" etc. for symbols; you shouldn't need a medical expert for that. If I get work done early today I'll try cloning the mathematical section in my user page for review. --Dnavarro (talk) 16:27, 23 October 2013 (UTC)

Eh well, take a look at the style in the beginning on User:Dnavarro. Too terse? —Preceding undated comment added 16:36, 23 October 2013 (UTC)
The request I noted above was answered at the now archived location at Help_talk:Displaying_a_formula/Archive_2#Help_with_line_breaking.2C_please, and I've added line-breaking to the article. I think it's acceptable as it is, but if you feel like rewriting the formulas to be more compressed as the example on your talk page I think you are very welcome to do so. Mikael Häggström (talk) 19:10, 24 October 2013 (UTC)

WHOIFPI[edit]

What is WHOIFPI??? I propose all references to this strange series of letters should be removed, unless explained in the right context. Is it a mnemonic? for what? why is there a mnemonic there? — Preceding unsigned comment added by 174.63.84.111 (talk) 05:10, 7 November 2013 (UTC)

The abbreviation is explained at least eight times in the article, directly in relation to the formulas where it is used, where it says it stands for "Would Have Occurred in the First Place in the Individual". Please let me know if yet another explanation is needed somewhere in the article for additional clarification. Mikael Häggström (talk) 06:02, 7 November 2013 (UTC)
On second thought, I just added a ninth explanation at the top of Differential_diagnosis#Theory just in case. Mikael Häggström (talk) 04:33, 8 November 2013 (UTC)

Temporary error[edit]

There is currently a temporary error in parsing some of the equations. It's noted (e.g. here) and should hopefully be fixed soon. Mikael Häggström (talk) 19:59, 7 February 2014 (UTC)

I see it's fixed now. Mikael Häggström (talk) 08:57, 30 March 2014 (UTC)

Cruelty to TeX[edit]

The way in which TeX code was misused in this article seems cruel to the software. And the use of an asterisk for ordinary multiplication within TeX is horribly vulgar. I've cleaned up most of it. Michael Hardy (talk) 02:57, 27 March 2014 (UTC)

Thanks for the cleanup. I've corrected the source article too. I can honorably mention you as "Formula cleanup by Michael Hardy" if you wish. Mikael Häggström (talk) 09:01, 30 March 2014 (UTC)
Which source article? Michael Hardy (talk) 05:17, 31 March 2014 (UTC)
It's located at Wikiversity:An epidemiology-based and a likelihood ratio-based method of differential diagnosis. Mikael Häggström (talk) 04:16, 1 April 2014 (UTC)

Citations[edit]

What to do with the citations previously referenced to Wikiversity is discussed at Wikipedia_talk:WikiProject_Medicine#.22Nomination.22_of_steroidogenesis_article_in_Wikiversity_to_be_used_as_reference. Mikael Häggström (talk) 10:01, 7 April 2014 (UTC)