Conceptualization of category-oriented likelihood ratio: a useful tool for clinical diagnostic reasoning

dc.creator	Moosapour Hamideh
dc.creator	Raza Mohsin
dc.creator	Rambod Mehdi
dc.creator	Soltani Akbar
dc.date	2011-11-01T00:00:00Z
dc.date.accessioned	2015-07-20T22:13:01Z
dc.date.available	2015-07-20T22:13:01Z
dc.identifier	10.1186/1472-6920-11-94
dc.identifier	1472-6920
dc.identifier	https://doaj.org/article/d8232e520b21425eb911fa0f84d7a2e6
dc.identifier.uri	http://evidence.thinkportal.org/handle/123456789/15698
dc.description	<p>Abstract</p> <p>Background</p> <p>In the diagnostic reasoning process medical students and novice physicians need to be made aware of the diagnostic values of the clinical findings (including history, signs, and symptoms) to make an appropriate diagnostic decision. Diagnostic reasoning has been understood in light of two paradigms on clinical reasoning: <it>problem solving </it>and <it>decision making</it>. They advocate the reasoning strategies used by expert physicians and the statistical models of reasoning, respectively. Evidence-based medicine (EBM) applies <it>decision theory </it>to the clinical diagnosis, which can be a challenging topic in medical education.</p> <p>This theoretical article tries to compare evidence-based diagnosis with expert-based strategies in clinical diagnosis and also defines a novel concept <it>of category-oriented likelihood ratio (LR) </it>to propose a new model combining both aforementioned methods.</p> <p>Discussion</p> <p>Evidence-based medicine advocates the use of quantitative evidence to estimate the probability of diseases more accurately and objectively; however, the published evidence for a given diagnosis cannot practically be utilized in primary care, especially if the patient is complaining of a nonspecific problem such as abdominal pain that could have a long list of differential diagnoses. In this case, expert physicians examine the key clinical findings that could differentiate between broader categories of diseases such as organic and non-organic disease categories to shorten the list of differential diagnoses. To approach nonspecific problems, not only do the experts revise the probability estimate of specific diseases, but also they revise the probability estimate of the <it>categories of diseases </it>by using the available clinical findings.</p> <p>Summary</p> <p>To make this approach analytical and objective, we need to know how much more likely it is for a key clinical finding to be present in patients with one of the diseases of a specific category versus those with a disease not included in that category. In this paper, we call this value <it>category-oriented LR</it>.</p>
dc.language	English
dc.publisher	BioMed Central
dc.relation	http://www.biomedcentral.com/1472-6920/11/94
dc.relation	https://doaj.org/toc/1472-6920
dc.rights	CC BY
dc.source	BMC Medical Education, Vol 11, Iss 1, p 94 (2011)
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	DOAJ:Medicine (General)
dc.subject	DOAJ:Health Sciences
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	DOAJ:Education
dc.subject	DOAJ:Social Sciences
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	DOAJ:Medicine (General)
dc.subject	DOAJ:Health Sciences
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	DOAJ:Education
dc.subject	DOAJ:Social Sciences
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.title	Conceptualization of category-oriented likelihood ratio: a useful tool for clinical diagnostic reasoning
dc.type	article