Diagnostic cues in gastroenterology. 1983

J I Balla, and D S Greenbaum, and M L Rothert, and N A Black

Twenty seven gastroenterologists (15 physicians and 12 surgeons) were studied to capture their policy in the usage and weighting of cues in making a diagnosis. This was a relatively small sample and on account of possible sampling bias only tentative generalisations will be made. Five case vignettes, each consisting of four to eight cues, were used. Subjects were asked to give their percentage likelihood estimates of various diagnostic possibilities after each cue. This gave an indication of their perception of the significance of various cues in relationship to each diagnosis. There were marked variations in cue weighting by these experts, and in particular, most individuals were far off the mean regarding the weighting of certain clinical features, thus displaying idiosyncratic behaviour in these instances. As may be expected, there were differences in disease prevalence estimates between physicians and surgeons. Early information had an overwhelming effect on the final diagnosis. In most cases the expert relied on a few critical cues rather than on a pattern to make a diagnosis. In view of the strong influences of early diagnostic formulations, these findings confirm the need for doctors to learn to use and collect accurate factual information on prevalence rates and on the most significant critical cues for various disease processes. The study highlights some of the problems faced by novices in learning from experts who may teach them contradictory information about what are the most significant factors in coming to a diagnosis.

UI MeSH Term Description Entries
D008297 Male Males
D008487 Medical History Taking Acquiring information from a patient on past medical conditions and treatments. Medical History, Previous,Past Medical History, Family,Previous Medical History,Family Health History,Family History, Health,Family History, Medical,Family Medical History,History Taking, Medical,Family Health Histories,Family Medical Histories,Health Family Histories,Health Family History,Health History, Family,History, Previous Medical,Medical Family Histories,Medical Family History,Medical Histories, Previous,Medical History, Family,Previous Medical Histories
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D003463 Cues Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. Cue
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D005767 Gastrointestinal Diseases Diseases in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Cholera Infantum,Gastrointestinal Disorders,Functional Gastrointestinal Disorders,Gastrointestinal Disorders, Functional,Disease, Gastrointestinal,Diseases, Gastrointestinal,Functional Gastrointestinal Disorder,Gastrointestinal Disease,Gastrointestinal Disorder,Gastrointestinal Disorder, Functional
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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