Nomenclature
Symptom
- Cause
- Source
Sign
Phenomena
Character
Type
Severity
Damage
Loss
Course
Duration
Possible
Probable
Odds
Confidence
Physical
Neurological
Psychogenic
Inherited
Acquired
Congenital
Genetic
Dysfunction
Condition
Disorder
Injury
Impairment
Deficit
Illness (“i feel ill”)
Pathology
Presentation
Manifestation
Etiology
Epidemiology
Risk factor
Predisposition
Examination
Evaluation
Provisional diagnosis
Differential diagnosis
Category
Class
Essentialist vs Nominalist Definitions
Nominalist
“nominalist approach the nature of an illness is decided by reference to a biomedical norm and the names are convenient devices by which the diagnostic process can be stated briefly.” “Thus meningococcal meningitis combines two diagnostic categories: meningococcal defines aetiology and cause, while meningitis defines the morbid anatomy”
“Nominalist definitions do not attempt the impossible task of revealing the essence of the condition defined but indicate how words relate to observable phenomena.”
Essentialist
“Essentialism is based on the Aristotelian notion that natural organisms show an invariant general pattern or essence shared by all members of the group.24 ‘He is sick with a cold’ recognises the general state of being ill and a vague cause which is generally understood in lay terms”
The inherent ambiguity of essentialism is not useful in science, and we should use nominalist terminology in medical discourse1
Disease
Disease has had many definitions since its inception in the 14th century1
What does it truly refer to?
- Descriptive or syndromal (eg, sarcoidosis)1
- Morbid–anatomical (eg, cancer)1
- Pathophysiological (eg, asthma)1
- Etiological (eg, tuberculosis)1
A disease is merely a concept which is only useful if it effectively frameworks, organizes, and explains the complexity of a clinical experience in order for the clinician or another clinician to make an accurate prognosis or choose an effective treatment2
Diagnosis
- verb: Diagnose
- Opposite: misdiagnosis
- lack: no diagnosis
| Part | Meaning | Origin |
|---|---|---|
| dia- | through | Greek δια (διά) |
| -gnosis | knowledge | Greek γνωσις (γνῶσις) |
Diagnosis implies the distinction of illness or disease from health1
Diagnosis can be broken into 3 levels:
- Category or class of disorder (e.g. neuromuscular disorder)1
- Specifies the subject (eg, 30-year-old female) to be diagnosed1
- More specific reaoned categorisation (autoimmune myasthenia gravis)1
What can be diagnosed?
- Described and recognisable combination of signs and symptoms and signs (i.e. vomiting and diarrhea)1
- Phenomena associated with a specified pathology or disorder of function (i.e. inflammation with altered gastrointestinal motility)1
- A specific cause or causes (i.e. bacillary dysentery or cholera)1
A Diagnosis can be defined as a hypothesis to describe a patient, their presentation, and the cause
Syndrome
- is it a concept
Syndrome: A recognizable complex of symptoms and physical findings (?signs?) which indicate a specific condition for which a direct cause is not necessarily understood2.
For example doctors will commonly use the phrase “viral syndrome” when they are uncertain which specific viral agent is causing the illness2.
Once the clinician or medical science identify the causative agent or process with high certainty, the process should be replaced with a disease label2.
For example “Kawasaki Syndrome” was upgraded to “Kawasaki Disease” when its diagnostic features, progression, and response to treatment was clearly defined2.