Differential diagnosis is a process that examines all possible causes for a set of symptoms to arrive at a diagnosis. Doctors gather evidence by interviewing the patient, conducting exams and tests, and considering possible causes before making a working diagnosis and beginning treatment. The process can be complicated and involves monitoring the patient’s condition and incorporating treatment failure into the diagnosis. It is an important part of internal medicine and can be used to assist other medical specialists.
In medicine, a differential diagnosis is a diagnosis that examines all possible causes for a set of symptoms to arrive at a diagnosis. For example, if a patient presents with a runny nose, doctors might consider causes such as hay fever and colds in the differential diagnosis in an effort to arrive at the correct diagnosis. Many doctors use this system of diagnosis in their practices and some doctors known as diagnosticians actually specialize in it.
To perform a differential diagnosis, the doctor begins by examining the patient’s case. He or she interviews the patient to gather symptoms, and also collects family, personal, and social history that provides an insight into the patient’s background. Typically, exams and tests are also included, to obtain specific information about the patient’s current condition. In a particularly puzzling case, the doctor might interview friends and colleagues or examine the patient’s natural environment to look for causes.
Once all the evidence is gathered, the doctor considers possible causes for the patient’s condition. Before any cause can be dismissed, the doctor must give a good reason. Multiple causes are not excluded in a differential diagnosis, as it is possible for patients to become ill with more than one thing at the same time. Once the doctor has considered all possible factors, he makes a working diagnosis and begins treatment.
The condition of the patient being treated is monitored, and if the patient does not improve or worsens, the doctor returns to the drawing board. Treatment failure is incorporated into the differential diagnosis and the doctor starts over. In one sense, this type of diagnosis is a process of elimination, but it can get extremely complicated and very complex, since many common diseases and afflictions look very similar and it is easy for a doctor to be misled.
Making a diagnosis using this method can be like putting the pieces of a puzzle together, especially when a patient has conflicting symptoms or a complex history. It is an important part of the practice of internal medicine, a medical specialty that focuses on the diagnosis and treatment of nonsurgical conditions in patients. Internists are sometimes called upon to assist other medical specialists with a differential diagnosis, as they are able to draw on a large body of knowledge and experience.
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