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Answer 1

Answer:

This chapter provides an overview of diagnosis in health care, including the committee's conceptual model of the diagnostic process and a review of clinical reasoning. Diagnosis has important implications for patient care, research, and policy. Diagnosis has been described as both a process and a classification scheme, or a “pre-existing set of categories agreed upon by the medical profession to designate a specific condition” (Jutel, 2009).1 When a diagnosis is accurate and made in a timely manner, a patient has the best opportunity for a positive health outcome because clinical decision making will be tailored to a correct understanding of the patient's health problem (Holmboe and Durning, 2014). In addition, public policy decisions are often influenced by diagnostic information, such as setting payment policies, resource allocation decisions, and research priorities (Jutel, 2009; Rosenberg, 2002; WHO, 2012).

The chapter describes important considerations in the diagnostic process, such as the roles of diagnostic uncertainty and time. It also highlights the mounting complexity of health care, due to the ever-increasing options for diagnostic testing2 and treatment, the rapidly rising levels of biomedical and clinical evidence to inform clinical practice, and the frequent comorbidities among patients due to the aging of the population (IOM, 2008, 2013b). The rising complexity of health care and the sheer volume of advances, coupled with clinician time constraints and cognitive limitations, have outstripped human capacity to apply this new knowledge. To help manage this complexity, the chapter concludes with a discussion of the role of clinical practice guidelines in informing decision making in the diagnostic process.

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