The diagnostic process is an intricate process that commences with a patient's ailment history that later on culminates into something that can be classified. It is imperative for a clinician to carefully assess the prognosis and offer effective treatment to the patient. The patient's symptoms will be presented by their own experiences, and their accuracy in spelling out their symptoms will help determine the nature of their prognosis. According to Sackett, there are four main strategies that can be used in the diagnostic procedure. They include pattern recognition, hypothetico-deductive strategy, algorithm strategy and the complete history. (Sackett, 1991). Pattern recognition refers to the instant identification of illness from the patient's explanation, while the hypothetical strategy requires the clinician to conduct a test and deduct an inference from the test.
A patient's detailed account of their experiences is what will determine the treatment they ought to be offered. A point in case is a patient that recently visited the hospital and complained of the following signs and symptoms, severe headaches, fever, diarrhea, pain in the whole body; especially abdominal pains and a lack of appetite. The patient's sign and symptoms revealed that she was suffering from Typhoid. The patient also disclosed that she had consumed contaminated milk the previous week, and had only slight stomach aches. She bought several painkillers, and the pain disappeared only to reappear a week later and raise discomfort to her body. She felt very weak and was not enthusiastic about doing anything. The illness persevered until she finally came to the hospital to seek medication. She was given several drugs that would reduce the pain and bring back her appetite as she was shading a lot of weight from the lack of food. It was only after two days that the patient came back to the hospital sweating profusely and not stable to do anything. She was quickly rushed to the examination room where several tests were carried out once again.
The patient was suffering from acute Malaria. Acute Malaria is a rare type of Malaria that rarely affects people, although a small percentage can easily contract it. The Malaria symptoms had incubated itself in her body for 10days since the time she was bitten. The patient was then offered all the anti-malaria drugs that have helped regain her appetite and reduced the pain she felt. This case was a peculiar one because the symptoms described by the patient were similar to the ones of Typhoid. The patient had also stated that she had taken contaminated milk, which was an obvious observation that she suffered from Typhoid. The results showed that diseases have very similar signs and symptoms that can lead to a misdiagnosis. Conducting tests keenly and attentively can result in the right outcome of a disease.
The clinician works with what has been presented to them by the patient, and the accumulation of signs and symptoms fostering the development of the illness is the plot of the disease. (Hunter,1991). The medical practitioner works with the patient's narrative, which is the plot or the diagnosis. (Hunter,1991). In the study case above, the patient had described themselves in a way that the signs pointed out to Typhoid by indicating that they had drank contaminated milk. This misled the clinician into the path of Typhoid, signing out Malaria, and thus conducting tests on Typhoid only to, later on, discover the illness. The patient's history is a necessary tool for diagnosing patients, and it requires vast clinical knowledge and experience. (Macnaughton, 1998).
The process of diagnosing starts with the doctor working with the information obtained from the patient, and establishing the pattern of their signs. They then make their deductions that they use in treating the patient.
Sackett DL, Haynes RB, Guyatt GH, Tugwell P. Clinical Epidemiology. Boston: Little, Brown and Co., 1991; 3“18.
Hunter KM. Doctors' Stories. Princeton: Princeton University Press, 1991; 44“47.
Macnaughton J. Anecdote in clinical practice. In Greenhalgh T, Hurwitz B (eds). Narrative Based Medicine. London: MJ Books, 1998; 202“211.
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