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Diagnostic reasoning in internal medicine: a practical reappraisal.
Corazza, Gino Roberto; Lenti, Marco Vincenzo; Howdle, Peter David.
  • Corazza GR; First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. gr.corazza@smatteo.pv.it.
  • Lenti MV; Emeritus Professor of Internal Medicine, Clinica Medica, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 19, 27100, Pavia, Italy. gr.corazza@smatteo.pv.it.
  • Howdle PD; First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
Intern Emerg Med ; 16(2): 273-279, 2021 03.
Article in English | MEDLINE | ID: covidwho-1137172
ABSTRACT
The practice of clinical medicine needs to be a very flexible discipline which can adapt promptly to continuously changing surrounding events. Despite the huge advances and progress made in recent decades, clinical reasoning to achieve an accurate diagnosis still seems to be the most appropriate and distinctive feature of clinical medicine. This is particularly evident in internal medicine where diagnostic boundaries are often blurred. Making a diagnosis is a multi-stage process which requires proper data collection, the formulation of an illness script and testing of the diagnostic hypothesis. To make sense of a number of variables, physicians may follow an analytical or an intuitive approach to clinical reasoning, depending on their personal experience and level of professionalism. Intuitive thinking is more typical of experienced physicians, but is not devoid of shortcomings. Particularly, the high risk of biases must be counteracted by de-biasing techniques, which require constant critical thinking. In this review, we discuss critically the current knowledge regarding diagnostic reasoning from an internal medicine perspective.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thinking / Diagnosis / Internal Medicine Type of study: Diagnostic study / Prognostic study Limits: Humans Language: English Journal: Intern Emerg Med Journal subject: Emergency Medicine / Internal Medicine Year: 2021 Document Type: Article Affiliation country: S11739-020-02580-0

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thinking / Diagnosis / Internal Medicine Type of study: Diagnostic study / Prognostic study Limits: Humans Language: English Journal: Intern Emerg Med Journal subject: Emergency Medicine / Internal Medicine Year: 2021 Document Type: Article Affiliation country: S11739-020-02580-0