On Sat, May 07, 2005 at 02:12:45PM +0100, Thomas Beale wrote: > If angina pectoris is a possible > diagnosis for "burning chest pain" at 5%, with the most probable > diagnosis (in the opinion of the physician) being "gastric reflux" at > 95%, and it is a 55-yo with a family history of coronary heart disease,
> I presume that the angina pectoris possibility is the one that drives > the next steps? How are the confidences really decided? If it's "a 55-yo with a family history of coronary heart disease" and the doctor thinks angina pectoris is at 5% while gastric reflux is at 95% then it is either a failure of the doctor to get his probabilites straight - or else the doctor is truly clueful (eg knows the patient very well) - in which case, yes, the gastric reflux would be driving the next steps. > How are we to bridge the gap between the physician-recorded confidence > factor and the total list of factors which drive the next steps? In such cases I usually record "IMO <this> but <that> not r/o yet hence act on <this> but also do <foo> to differentiate". In clear text. Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
