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					  Diagnosis
What’s in a Name?
      Diagnosis as Classification
        Gait/Walk Distance Dysfunction
              Associated with COPD

   Does the title identify a homogeneous group?
   Does the title reflect, “what’s wrong”?
   Label implies the COPD is the factor that affects
    the gait and/or distance walked (Essentialism).
   Label may also imply that the diagnostic exam
    was a “Gait/Walk Distance Test”
   Are there “gold standard” diagnostic tests?
   Does this “Diagnosis” direct treatment/broadness
    of the category?
           Diagnosis: Syndrome
   Pusher Syndrome (Nominalist)

   Is the group discrete/homogeneous?
   Does it meet the definition of a “Syndrome” eg.
    Signs, symptoms, clinical tests to rule in/out
   Use of a “known term”/helpful or not?
   Is this a Movement System Syndrome?
   Is there relevance of this classification to natural
    history, prognosis, intervention for this group?
         Descriptive Diagnosis
     Loss   of Skin Integrity Associated
               with Venous Stasis

   Does the title describe the group
   Are the tests to identify and classify the patients
    w/in scope of PT Practice?
   Classified as a Movement System Dx?
   Label identifies cause and/or directs treatment
    specific to this diagnosis?
          Diagnosis Dialog


 What   do YOU think?
    Diagnosis as Process to Classify
       Label Example: Gait Distance Dysfunction
        Associated with Intermittent Claudication

   The diagnostic process uses history, signs and symptoms,
    tests and measures to identify common findings that can
    classify patients into groups to be labeled similarly
   What is the dysfunction…is the Gait the problem?
   Label implies the Intermittent Claudication is the factor that
    limits the gait and/or distance.
   Label may also imply that the diagnostic exam was a “Gait
    Distance Test”
   Change title to “Walk Distance Dysfunction”?
Diagnosis Label With Model Language

   Example: Gait Distance Dysfunction Associated
    with Chronic Obstructive Pulmonary Disease

   Considering existing models, (eg Nagi, NCMRR,
    ICF), this could be classified as a mobility related
    “activity/participation” diagnosis assoc/pathology
   Does this diagnostic label direct treatment?
   Can we identify the cluster of signs, symptoms
    and test findings that would classify the patients
    that belong in this group?
          Differential Diagnosis
     Example: Loss of Skin Integrity Associated
                    with Venous Stasis
   Does this title allow the PT to group patients by
    common impairment, (eg loss of integrity), and
    identify the causal factor?
   Does the title direct how the PT plans the
    treatment program, (eg. differently for this group
    when compared to loss of integrity for a different
    pathology/impairment)
   Can PT intervention address/correct the problem?
        Screening for Diagnosis
    Example: Loss of Joint Mobility
    Associated with Hypertrophic Scar

 Screening implies ruling in and out
  through diagnostic testing to classify
 Title implies a general category of
  impairment and a causative pathology
 Does title direct treatment planning and
  measured outcome?

				
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posted:12/15/2011
language:English
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