2014, Number 4
Reasoning with the Signs and Symptoms
Santana-Chávez LA, Esparza-Pérez RI
Full text
Language: Spanish
References: 7
Page: 442-450
PDF size: 469.54 Kb.
ABSTRACT
The reasoning processes allow us to relate data to obtain provisional or definitive conclusions. The clinician uses various strategies in the diagnostic process. These require a structured method to provide adequate reasoning with the information gathered by this clinician (signs, symptoms, diagnostic tests). Signs and symptoms help us to provide better care to patients with regard to diagnosis, prognosis and treatment. The tool that helps us to identify the weight of these signs and symptoms is the likelihood ratio (LR), which tells us how likely is that, having the sign or symptom “A”, the patient has the disease “X”, in comparison with the patient “Y” that does not have the sign or symptom “A”. Many of the signs and symptoms are subjective and depend on the capacity of observation, comparison and classification of the clinician. Such subjectivity is open to different interpretations as both interpersonal and intrapersonal. To avoid these variations we require tools such as the Kappa index. Using LR and Kappa indexes allows us to increase the diagnostic probability, with less subjectivity and always relied on the best available evidence.REFERENCES