|
In medicine, a differential diagnosis is the distinguishing of a particular disease or condition from others that present similar symptoms.〔(【引用サイトリンク】url=http://www.merriam-webster.com/dictionary/differential+diagnosis?show=0&t=1419934834 )〕 Differential diagnostic procedures are used by physicians and other trained medical professionals to diagnose the specific disease in a patient, or, at least, to eliminate any imminently life-threatening conditions. Often each individual option of a possible disease is called a differential diagnosis (for example, bronchitis could be a differential diagnosis in the evaluation of a cough that ends up with a final diagnosis of common cold). More generally, a differential diagnostic procedure is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible. This method is essentially a process of elimination or at least a process of obtaining information that shrinks the "probabilities" of candidate conditions to negligible levels, by using evidence such as symptoms, patient history, and medical knowledge to adjust epistemic confidences in the mind of the diagnostician (or, for computerized or computer-assisted diagnosis, the software of the system). Differential diagnosis can be regarded as implementing aspects of the hypothetico-deductive method, in the sense that the potential presence of candidate diseases or conditions can be viewed as hypotheses that physicians further determine as being true or false. Common abbreviations of the term "differential diagnosis" include DDx, ddx, DD, D/Dx, or ΔΔ. ==General components== There are various methods of performing a differential diagnostic procedure, but in general, it is based on the idea that one begins by considering the most common diagnosis first: a head cold versus meningitis, for example. As a reminder, medical students are taught the Occam's razor adage, "When you hear hoofbeats, look for horses, not zebras," which means look for the simplest, most common explanation first. Only after ruling out the simplest diagnosis should the clinician consider more complex or exotic diagnoses. Differential diagnosis has four steps. The physician: # Gathers all information about the patient and creates a symptoms list. The list can be in writing or in the physician's head, as long as they make a list. # Lists all possible causes (''candidate conditions'') for the symptoms. Again, this can be in writing or in the physician's head but it must be done. # Prioritizes the list by placing the most urgently dangerous possible causes at the top of the list. # Rules out or treats possible causes, beginning with the most urgently dangerous condition and working down the list. ''Rule out''—practically—means use tests and other scientific methods to determine that a candidate condition has a clinically negligible probability of being the cause. In some cases, there remains ''no'' diagnosis. This suggests the physician has made an error, or that the true diagnosis is unknown to medicine. The physician removes diagnoses from the list by observing and applying tests that produce different results, depending on which diagnosis is correct. A mnemonic to help in considering multiple possible pathological processes is ''VINDICATE'M'': *Vascular *Inflammatory/Infectious *Neoplastic *Degenerative/Deficiency/Drugs *Idiopathic/Intoxication/Iatrogenic *Congenital *Autoimmune/Allergic/Anatomic *Traumatic *Endocrine/Environmental *Metabolic〔Cf. ( VINDICATE – Mnemonic for differential diagnosis ) at PG Blazer.com.〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Differential diagnosis」の詳細全文を読む スポンサード リンク
|