DefinePK

Abstract

Introduction


Clinical decision making refers to any act of diagnosis that leads to a decision regarding prognosis, treatment, referral, or counseling. Diagnosis itself passes through a series of stages, beginning with the assessment of symptoms. However, the meaning of symptoms varies greatly with the context. For example, diagnostic outcomes for cough presenting in general practice differ from those seen in the context of a chest clinic. Persons presenting with severe headache at a neurology clinic are more likely to have a brain tumor than those presenting with a similar complaint in an emergency clinic. In light of presenting symptoms, the clinician then proceeds to the stage of diagnostic hypotheses, generally restricting the serious possibilities to less than four (said to relate more to the limitations of short term memory than to the intrinsic validity of any such restriction).1 He or she then attempts to use available evidence to differentiate among these hypotheses. Ideally, this leads to isolating a single diagnostic entity. Consequent upon this, a prognosis is made, and a course of treatment identified. However, potential for error exists at all stages in this process, and actions, whether valid or invalid, have consequences.