The Trivialization of Diagnosis
The Trivialization of Diagnosis
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DOI：
10.1002/jhm.550
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发表时间：
2010-02-01
影响因子：
2.6
通讯作者：
Gaitonde, Shilpa
中科院分区：
文献类型：
--
作者：
Kushner, Irving;Greco, Peter J.;Gaitonde, Shilpa
尽管人们普遍认为诊断在临床医学中起着核心作用，但近年来，诊断的首要地位受到了来自几个方面的攻击。1. “计费条款”正在取代传统的医疗诊断。前者是基于国际疾病分类清单，其中包括许多非诊断，如症状和体征。2. 诊断往往被忽视，因为他们认为出院的紧迫性。3. 在实践中，以问题为导向的记录经常导致重点从综合发现转向问题的碎片化。4. 即使不正确，推定的诊断也经常在医疗记录中演变成确定的诊断。5. 许多作者显然贬低了诊断的重要性。尽管如此，很明显，诊断必须继续在临床医学中发挥核心作用。我们提出了几种方法，通过这些方法我们可以抵抗这些力量，并确保诊断保持其适当的首要地位。医院医学杂志2010；5:116-119。(C) 2010年医院医学会。
Although it is widely recognized that diagnosis plays a central role in clinical medicine, in recent years the primacy of diagnosis has come under attack from several sources. 1. "Billable terms" are replacing traditional medical diagnoses. The former are based on International Classification of Diseases lists, which include many non-diagnoses such as symptoms and signs. 2. Diagnosis often gets short shrift because of the perceived urgency of discharge. 3. The problem oriented record, in practice, has frequently led to a shift in emphasis from synthesis of findings to fragmentation of problems. 4. Presumptive diagnoses frequently metamorphose into established diagnoses in medical records, even if incorrect. 5. A number of authors have apparently disparaged the importance of diagnosis. Nonetheless, it is clear that diagnosis must continue to play a central role in clinical medicine. We propose several ways by which we can resist these forces and assure that diagnosis retains its appropriate position of primacy. Journal of Hospital Medicine 2010;5:116-119. (C) 2010 Society of Hospital Medicine.