Differential diagnosis and prognosis

This first term refers to a range of diagnoses when several possibilities are suggested by the patient’s symptoms and the findings of the investigations. The differential diagnosis usually narrows as the doctor proceeds from taking the patient’s history to examina- v A computer can be used in making a diagnosis. The patient sits in front of the screen and answers questions put by the computer. A doctor has to be present at the beginning to get the patient used to it. Once the procedure is understood it is often found that the answers given by patients are much more accurate and honest than those they give to their doctor. The phenomenon may be explained by the fact that, in contrast to a doctor, a computer does not react in a condemnatory way when questions on, for ex- ample, alcohol consumption are answered. The final diagnosis and, of course, the recommended treatment are made by the doctor. The use of computers in this way releases a lot of doctor’s time and contributes to a data bank of medical statistics, which becomes invaluable in research into patterns of incidence of particular disorders.

Tion and special tests, so that ideally he is left with only one diagnosis at the finish. Prognosis is the term used for the outlook or expected outcome of an illness. It may of course alter with treatment. For example, the prognosis of the common cold is excellent; all uncomplicated cases recover in seven days, with any treatment or none. The prognosis of patients with untreated acute appendicitis is conservative, because a significant proportion of such cases die. For appendicitis treated by operation the prognosis is very good, and almost every patient recovers rapidly and completely.

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