Re: Client menu suggestions was Re: [Gnumed-devel] Release 0.5.rc2

[Elizabeth Dodd]

On Mon, 29 Jun 2009, Karsten Hilbert wrote:
> > - although I take "History taking" and "Observations" to be patterned  
> > after the traditional sequence of data gathering, they create or enforce
> > sometimes artificial distinctions, as history and observations are both
> > in reality also (alternatively) inputted via SOAP notes.
>
> I thought as much but wanted to hear it independently.

There is a lovely essay on the actual heuristics of making a diagnosis.
I think it is from a book published about 1978

but since then the work has progressed
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1122649
http://fampra.oxfordjournals.org/cgi/content/full/18/3/243
http://www.bmj.com/cgi/content/full/324/7339/729


It has nothing to do with SOAP or the older method we were supposed to use 30 
years ago 
presenting complaint
history of present illness
other health matters
social history
examination by "system" - cardiac and respiratory being artificially separated
usw


Anyway, I'm just putting this up because whatever record structure Gnumed has 
needs to be able to support any of the different ways in which we make a 
diagnosis
Diagnosis as selecting a hypothesis
Pattern recognition or categorisation
Diagnosis as opinion revision 
Probability transformations 

and I'm not in favour of any particular means of recording

-- 
You have a deep appreciation of the arts and music.