scholarly journals Adding value to the diagnostic process

2021 ◽  
pp. bmjqs-2021-014092
Author(s):  
Laurien Kuhrij ◽  
Perla J Marang-van de Mheen
Keyword(s):  
Diagnostic Process

Counseling Parents at the Time of Diagnosis: Moving Toward Client-Centered Practice

2020 ◽  
pp. 1-5
Author(s):  
David Luterman
Keyword(s):  
Case History ◽  
Medical Model ◽  
Diagnostic Process ◽  
Separate Entity ◽  
Initial Examination ◽  
Personal Adjustment ◽  
Flow Of Information ◽  
Ultimate Purpose

Purpose The purpose of this article is to present a client-centered model of counseling that integrates information and personal adjustment counseling. Research has indicated that audiologists are more comfortable with counseling that is information based than with personal adjustment counseling. The prevailing model of diagnosis appears to be the medical model in which, first, a case history is taken, then testing and, finally, counseling. This model lends itself to audiologist as expert and the counseling as a separate entity based on information and advice. Further research has indicated parents retain little of the information provided in the initial examination because of their heightened emotions. This article presents a client-centered model of diagnosis in which information is provided within an emotionally safe context, enabling the parents to express their feelings and have the ability to control the flow of information. The ultimate purpose of a client-centered model is to empower parents by making them active participants in the diagnostic process rather than passive recipients. Conclusion The client-centered model has wide implications for the diagnostic process as well as for the training of students.

Perceptual Characteristics of Consonant Production in Apraxia of Speech and Aphasia

2019 ◽  
Vol 28 (4) ◽  
pp. 1411-1431 ◽  
Author(s):  
Lauren Bislick ◽  
William D. Hula
Keyword(s):  
Error Rate ◽  
Error Rates ◽  
Group Differences ◽  
Diagnostic Process ◽  
Apraxia Of Speech ◽  
Contextual Variables ◽  
Error Type ◽  
Type Distribution ◽  
Phonetic Features ◽  
Syllable Position

Purpose This retrospective analysis examined group differences in error rate across 4 contextual variables (clusters vs. singletons, syllable position, number of syllables, and articulatory phonetic features) in adults with apraxia of speech (AOS) and adults with aphasia only. Group differences in the distribution of error type across contextual variables were also examined. Method Ten individuals with acquired AOS and aphasia and 11 individuals with aphasia participated in this study. In the context of a 2-group experimental design, the influence of 4 contextual variables on error rate and error type distribution was examined via repetition of 29 multisyllabic words. Error rates were analyzed using Bayesian methods, whereas distribution of error type was examined via descriptive statistics. Results There were 4 findings of robust differences between the 2 groups. These differences were found for syllable position, number of syllables, manner of articulation, and voicing. Group differences were less robust for clusters versus singletons and place of articulation. Results of error type distribution show a high proportion of distortion and substitution errors in speakers with AOS and a high proportion of substitution and omission errors in speakers with aphasia. Conclusion Findings add to the continued effort to improve the understanding and assessment of AOS and aphasia. Several contextual variables more consistently influenced breakdown in participants with AOS compared to participants with aphasia and should be considered during the diagnostic process. Supplemental Material https://doi.org/10.23641/asha.9701690

Structured Interview for Hoarding Disorder (SIHD)

2019 ◽  
Vol 35 (4) ◽  
pp. 512-520
Author(s):  
Caterina Novara ◽  
Paolo Cavedini ◽  
Stella Dorz ◽  
Susanna Pardini ◽  
Claudio Sica
Keyword(s):  
Convergent Validity ◽  
Structured Interview ◽  
Diagnostic Process ◽  
Schizophrenia Spectrum Disorders ◽  
Clinical Environment ◽  
Obsessive Compulsive ◽  
Rater Reliability ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum

Abstract. The Structured Interview for Hoarding Disorder (SIHD) is a semi-structured interview designed to assist clinicians in diagnosing a hoarding disorder (HD). This study aimed to validate the Italian version of the SIHD. For this purpose, its inter-rater reliability has been analyzed as well as its ability to differentiate HD from other disorders often comorbid. The sample was composed of 74 inpatients who had been diagnosed within their clinical environment: 9 with HD, 11 with obsessive-compulsive disorder (OCD) and HD, 22 with OCD, 19 with major depressive disorder (MDD), and 13 with schizophrenia spectrum disorders (SSD). The results obtained indicated “substantial” or “perfect” inter-rater reliability for all the core HD criteria, HD diagnosis, and specifiers. The SIHD differentiated between subjects suffering from and not suffering from a HD. Finally, the results indicated “good” convergent validity and high scores were shown in terms of both sensitivity and specificity for HD diagnosis. Altogether, the SIHD represents a useful instrument for evaluating the presence of HD and is a helpful tool for the clinician during the diagnostic process.

Imprecision of Laboratory Determinations and Diagnostic Accuracy: Theoretical Considerations

1974 ◽  
Vol 13 (03) ◽  
pp. 151-158 ◽  
Author(s):  
D. A. B. Lindbebo ◽  
Fr. R. Watson
Keyword(s):  
Mathematical Model ◽  
Diagnostic Accuracy ◽  
Diagnostic Process ◽  
Clinical Laboratories ◽  
Non Linear ◽  
Theoretical Considerations ◽  
Made In

Recent studies suggest the determinations of clinical laboratories must be made more precise than at present. This paper presents a means of examining benefits of improvement in precision. To do this we use a mathematical model of the effect upon the diagnostic process of imprecision in measurements and the influence upon these two of Importance of Diagnosis and Prevalence of Disease. The interaction of these effects is grossly non-linear. There is therefore no proper intuitive answer to questions involving these matters. The effects can always, however, be calculated.Including a great many assumptions the modeling suggests that improvements in precision of any determination ought probably to be made in hospital rather than screening laboratories, unless Importance of Diagnosis is extremely high.

Acute abdomen in pregnancy: a retrospective study of pregnant patients hospitalised for abdominal pain

2020 ◽  
Vol 99 (3) ◽  
pp. 131-135
Keyword(s):  
Abdominal Pain ◽  
Clinical Signs ◽  
University Hospital ◽  
Diagnostic Process ◽  
Abdominal Emergency ◽  
Lower Abdominal Quadrant ◽  
Abdominal Emergencies ◽  
The Right ◽  
Abdominal Quadrant ◽  
In Pregnancy

Introduction: Abdominal emergencies occur in pregnant women with the rate of 1:500−635 pregnancies. Such conditions usually develop from full health and worsen rapidly. Symptoms are often similar to those in physiological pregnancy (abdominal pain, vomiting, constipation). The diagnostic process is thus difficult and both the mother and her child are at risk. Our aim was to evaluate the frequency of abdominal emergencies in the Department of Surgery, University Hospital in Pilsen and to consider their impact on pregnancy and on the newborn. Methods: We acquired a set of patients by retrograde collection of data. We searched for pregnant patients suspected of developing an abdominal emergency admitted to the Department of Surgery, Faculty of Medicine, Pilsen between 2004 and 2015. We evaluated a number of clinical signs to statistically describe the set. Results: The set included 121 patients; 42 of the patients underwent a surgical procedure and 79 received conservative treatment. 38 patients underwent appendectomy; 6 appendixes were with no pathologies. McBurney’s incision was an approach of choice in most cases. The most frequent symptom was pain in the right lower abdominal quadrant. The foetus has been lost in none of the cases. Conclusion: Acute appendicitis was the most frequent abdominal emergency in our set and also the most frequent reason for surgical intervention. The most specific sign was pain in the right lower abdominal quadrant. No impact of appendicitis or appendectomy on the health of the newborn has been observed. Even though abdominal emergencies in pregnancy are relatively rare, the results of the department are very good.

Normal cerebral ventricular volume growth in childhood

2020 ◽  
Vol 26 (5) ◽  
pp. 517-524
Author(s):  
Noah S. Cutler ◽  
Sudharsan Srinivasan ◽  
Bryan L. Aaron ◽  
Sharath Kumar Anand ◽  
Michael S. Kang ◽  
...  
Keyword(s):  
Brain Mri ◽  
Volume Growth ◽  
Ventricular Volume ◽  
Growth Patterns ◽  
Diagnostic Process ◽  
Growth Charts ◽  
Normal Brain ◽  
Mr Images ◽  
Ventricular Volumes ◽  
Brain Mr Images

OBJECTIVENormal percentile growth charts for head circumference, length, and weight are well-established tools for clinicians to detect abnormal growth patterns. Currently, no standard exists for evaluating normal size or growth of cerebral ventricular volume. The current standard practice relies on clinical experience for a subjective assessment of cerebral ventricular size to determine whether a patient is outside the normal volume range. An improved definition of normal ventricular volumes would facilitate a more data-driven diagnostic process. The authors sought to develop a growth curve of cerebral ventricular volumes using a large number of normal pediatric brain MR images.METHODSThe authors performed a retrospective analysis of patients aged 0 to 18 years, who were evaluated at their institution between 2009 and 2016 with brain MRI performed for headaches, convulsions, or head injury. Patients were excluded for diagnoses of hydrocephalus, congenital brain malformations, intracranial hemorrhage, meningitis, or intracranial mass lesions established at any time during a 3- to 10-year follow-up. The volume of the cerebral ventricles for each T2-weighted MRI sequence was calculated with a custom semiautomated segmentation program written in MATLAB. Normal percentile curves were calculated using the lambda-mu-sigma smoothing method.RESULTSVentricular volume was calculated for 687 normal brain MR images obtained in 617 different patients. A chart with standardized growth curves was developed from this set of normal ventricular volumes representing the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles. The charted data were binned by age at scan date by 3-month intervals for ages 0–1 year, 6-month intervals for ages 1–3 years, and 12-month intervals for ages 3–18 years. Additional percentile values were calculated for boys only and girls only.CONCLUSIONSThe authors developed centile estimation growth charts of normal 3D ventricular volumes measured on brain MRI for pediatric patients. These charts may serve as a quantitative clinical reference to help discern normal variance from pathologic ventriculomegaly.

Problems of pathology related to the dermatovenerology field in the emergency hospital

2020 ◽  
pp. 45-52
Author(s):  
I. Barsukova ◽  
I. Bagretsova
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Emergency Care ◽  
Diagnostic Process ◽  
Emergency Hospital ◽  
New Models ◽  
Hospital Development

Development of a system for the delivery of emergency care in a hospital inevitably raises questions of its availability and quality. And, if the leading pathological syndrome which is a reason for hospitalization and posing a threat to the patient's life deserves priority attention, then the accompanying pathology often stays in the background. At the same time the accompanying pathology related to the field of dermatovenerology poses epidemiological threat. The aim of the study was to improve the organization of health care for patients with concomitant pathology related to dermatovenerology in an emergency hospital. Development of new models and principles of the organization of medical and diagnostic process, introduction of methods of express diagnostics is required; importance of a dermatovenerologist becomes obvious, it will increase the availability and quality of care for patients with dermatovenereological pathology in an emergency hospital.

African American Women and Depression: Promoting the Need for Culturally Competent Treatment

2018 ◽  
Author(s):  
Bernice Kennedy ◽  
Chalice Jenkins ◽  
Keyword(s):  
Mental Health ◽  
African American ◽  
Depressive Symptoms ◽  
African American Women ◽  
Mental Health Problems ◽  
American Woman ◽  
Stressful Events ◽  
Mental Illnesses ◽  
Diagnostic Process ◽  
American Women

Abstract Depression is gradually increasing in African American women. These women are experiencing role changes and additional life stressors. Depressed African American women may perceive themselves as being devalued by society with fewer support systems to buffer stressful events. Depressive symptoms may develop into clinical depression and a further decrease in the quality of life for the African American woman. The assumption that all women share similar experiences does not allow for differences to emerge regarding the diagnostic process, measuring tools, and successful treatment strategies for various cultures. The authors developed a Multifaceted Model of Depression in African American Women for improving treatment of African American women with depression and future research needs. Cultural background plays a vital role in how the symptoms of mental illnesses are developed, reported, interpreted, and how women are treated. African Americans who subscribed to the Strong Black Women Archetype (SBWA) are naturally strong, resilient, self-contained, and self-sacrificing. This self-reliance prevents them from reaching out for social support. This, in turn, can contribute to depressive symptoms with negative health outcomes. The African American women are more apt to have less access to routine medical care where early diagnosis and interventions can be done, so their mental health problems (e.g., depression, stress, etc.) are often more developed, complicated, and their social supports more depleted when they do access treatment. When African American women do have access to mental health care, they receive poor quality care compared to Whites.

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