Diagnostics (i.e. making a diagnosis) is the process of recognizing a disease, which includes targeted medical examinations along with the interpretation of the results obtained and their summary in the form of an established diagnosis.
What does diagnostics include?
Diagnosis includes three basic sections:
- Semiotics.
- Methods of diagnostic examination (or diagnostic technique).
- Performing a differential diagnosis.
Types of diagnosis
At the stage of examination and therapy of the patient, the diagnosis can be constantly updated. In this regard, respectively, allocate:
- Preliminary diagnosis. That is, a diagnosis that is formulated directly as part of the patient's request for medical help, based on the data of the primary examination. stagingpreliminary diagnosis is often erroneous.
- The main diagnosis is based on clinical examinations.
- The final diagnosis is formulated upon completion of the examination and therapy of the patient, and in addition, in connection with his discharge from a medical institution or due to death.
Diagnosis on the Internet
Among other things, today we should recognize the presence of an early, and at the same time non-medical stage in the diagnosis, we are talking about self-diagnosis (that is, the so-called diagnosis on the Internet). Thanks to modern conditions, any person manages to find the symptoms of interest to him on the Internet. Based on the information received on the Web, people draw conclusions. But such conclusions will be biased, and besides, unfounded, and besides, intimidating the patient.
Difficulties in making a diagnosis and errors
There are more than a hundred million different diseases, and every day more and more new pathologies appear. Each disease has a described classical clinical picture, which is studied by medical students, but almost every pathology also has various forms along with degrees of severity, course options, atypical manifestations, and so on. Do not forget that a patient can simultaneously have several diseases at once, some manifestations and symptoms are superimposed on others. In addition, there are all sorts of complications that also change the classic manifestation of pathology.
Allpeople are fundamentally different. Each has its own morphology along with metabolism and protective reactions of the body. The same pathology can manifest itself in completely different ways in patients. Very often, the patient himself can contribute to a change in the clinical picture, for example, by taking medications without a doctor's prescription. And, of course, patients can distort information and lie.
Doctor Factor
Of course, the occurrence of errors in the diagnosis is often influenced by the factor of the doctor. All doctors are, first of all, the same people as their patients, and, as you know, everyone makes mistakes. A doctor may simply not know or simply forget about a particular disease or medical nuance. A doctor may simply not have enough experience, or, conversely, many years of practice of monotonous clinical activity will cloud the conduct of a complex differential diagnosis. Physicians have low salaries, in connection with this, many of them work several jobs at once or often are on duty at night. And against the backdrop of all this, fatigue can negatively affect the entire work as a whole.
Thus, in fact, errors in diagnosis are the most common type of medical error. In most situations, their appearance directly depends not so much on the lack of knowledge, but on the banal inability to use it. Chaotic diagnostic searches, even with the use of the most modern special techniques, are unproductive.
Consider below the basic rules for stagingdiagnosis.
Formulation of the diagnosis
The conclusion of the whole diagnostic process is the formulation of the diagnosis. It should contain the name of a specific disease, reflecting its essence. The elements of a clinical diagnosis clarify this essence (by pathogenesis, etiology, functional disorders, etc.) or give an idea of the course of the disease, which can be acute, subacute, protracted or chronic.
After the diagnosis is made, treatment is selected.
In addition, the formulation of the diagnosis contains information about the complications of the pathology, the period of exacerbations or remissions, its stages, and in the presence of inflammatory processes, the phases of the disease (active or inactive) and the degree of its activity.
Psychological diagnosis
The practice of using a variety of psychodiagnostic tests to study personality is inextricably linked with the concept of psychological diagnosis. The very concept of "diagnosis" (that is, the research procedure) is widely used in completely different areas, since the task of recognizing, and in addition, determining the characteristics of certain manifestations is not at all considered only the prerogative of medicine.
In the literature there are many definitions for such a thing as "psychological diagnosis". The medical definition of diagnosis, which is strongly associated with illness and deviations from the norm, was also reflected in the characterization of this concept in the field of psychological science. In this understanding, a psychological diagnosis always serves to reveal the hidden causes of the revealedtroubles. Diagnostics, wherever it is put, whether in medicine, in management or in the field of psychology, is always primarily a search combined with the identification of hidden causes. Next, consider what constitutes a clinical diagnosis.
Clinical Diagnosis
Clinical diagnosis is a complete subjective conclusion obtained in the course of differential diagnosis, which is a relative objective truth. Clinical diagnosis must be made within a period that does not exceed three days of the patient's stay in the hospital. Such a diagnosis must be made on the title page, indicating the date of its installation and the signature of the doctor who made the diagnosis. The date of the clinical diagnosis and the day of its justification must match in the medical history.
In the event that the diagnosis is not in doubt already within the framework of the initial examination of the patient (especially in cases of frequent hospitalization of a person in a certain department), then the correct diagnosis can be justified and formulated immediately on the day the person is admitted to the hospital.
Requirements
In the process of substantiating and formalizing a clinical diagnosis, certain requirements must be met, for example:
The diagnosis must be formulated on the basis of nosological principles, and at the same time it must be uniform along with full encryption, taking into account the accepted international classification of pathologies of the last revision. In addition, expressions and terms that allow contradictory and dual encryption should be avoided. In addition, the eponymous (named) designation of pathologies and syndromes is undesirable
What are the other criteria for diagnosis?
- Clinical diagnosis must be complete. In order to more fully disclose the features of a particular case, and at the same time, for greater diagnostic information, it is necessary to apply the generally accepted classification with additional intranosological characteristics (we are talking about the clinical form, syndrome, type of course, degree of activity, stage, functional disorders, and so on).
- Justification of the diagnosis should be carried out according to each nuance of the formulated conclusion. Significant, and in addition, significant symptoms with signs, in combination with the results of the differential diagnosis, indicating the pathologies that are included in the scope of the study, should be used as criteria within the justification of the diagnosis. Pathology recognition path should be as economical as possible.
- The clinical diagnosis during observation and therapy should be reviewed critically, and in addition, supplemented and refined. It should reflect the dynamics of structural and functional damage, changes in the patient's condition (phase change, stage, degree of compensation). It should also take into account the addition of complications, intercurrent diseases, as well as the favorable and unfavorable consequences of treatment and rehabilitation. Diagnosis rules must be strictly followed.
- Diagnosis must betimely and installed as soon as possible.
- In the course of formulating a clinical diagnosis, the underlying disease, its complications and comorbidities are consistently indicated.
Now consider methods for diagnosing pathologies.
Diagnostic Methods
Modern medicine is rich in various possibilities for conducting a detailed study of the functioning of organs and their structure. Nowadays, it is possible to quickly and accurately diagnose diseases and any deviations from the norm. Laboratory diagnostic methods reflect problems at the cellular and subcellular levels to a greater extent. Thanks to the methods of diagnosis, it is possible to judge the breakdowns that occur in specific organs. In order to see what exactly is happening in a particular organ, in particular, instrumental diagnostic methods are used.
Some studies are used only to identify a particular pathology. True, many diagnostic procedures are inherently universal and are used by doctors of various speci alties. Screening tests are carried out to identify pathologies whose symptoms have not yet manifested themselves or are weakly noticeable. An example of such a test is fluorography, which allows you to detect lung diseases at various stages. Screening tests are quite accurate. The research procedure itself is relatively inexpensive, and its implementation is not harmful to he alth.
Clinical analysisblood
Screening tests include some laboratory diagnostic methods in the form of blood and urine tests. The most common study is the well-known clinical blood test, which is the main way to evaluate blood cells. Blood for research purposes is usually obtained from finger capillaries.
In addition to the number of elements such as erythrocytes, leukocytes and platelets, the percentage of hemoglobin, the size and shape of cells, and so on are determined. In addition, using this diagnostic method, the number of reticulocytes (that is, immature red blood cells that have a nucleus) is determined. A clinical blood test makes it possible to diagnose most blood pathologies (anemia, leukemia, and others), and in addition, to evaluate the dynamics of inflammatory processes along with the effectiveness of the therapy. And thanks to the methods of diagnosis, in general, it is possible to detect developing pathologies in time.
