Novel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics?
Abstract Medical approach to patients is a fundamental step to get the correct diagnosis. The aim of this paper is to analyze some aspects of the reasoning process inherent in medical diagnosis in our era. Pathologic signs (anamnestic data, symptoms, semiotics, laboratory and strumental findings) re...
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doaj-43bf51bebae54fe8b2d7cf3828d299c52020-11-25T01:48:43ZengPAGEPress PublicationsMultidisciplinary Respiratory Medicine2049-69582017-06-011211810.1186/s40248-017-0098-zNovel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics?Gino Soldati0Andrea Smargiassi1Alberto A. Mariani2Riccardo Inchingolo3Emergency Department, Valle del Serchio General HospitalPulmonary Medicine Department, University Hospital “A. Gemelli” - Università Cattolica del Sacro CuoreEmergency Department, Valle del Serchio General HospitalPulmonary Medicine Department, University Hospital “A. Gemelli” - Università Cattolica del Sacro CuoreAbstract Medical approach to patients is a fundamental step to get the correct diagnosis. The aim of this paper is to analyze some aspects of the reasoning process inherent in medical diagnosis in our era. Pathologic signs (anamnestic data, symptoms, semiotics, laboratory and strumental findings) represent informative phenomena to be integrated for inferring a diagnosis. Thus, diagnosis begins with “signs” and finishes in a probability of disease. The abductive reasoning process is the generation of a hypothesis to explain one or more observations (signs) in order to decide between alternative explanations searching the best one. This process is iterative during the diagnostic activity while collecting further observations and it could be creative generating new knowledge about what has not been experienced before. In the clinical setting the abductive process is not only theoretical, conversely the physical exploitation of the patient (palpation, percussion, auscultation) is always crucial. Through this manipulative abduction, new and still unexpressed information is discovered and evaluated and physicians are able “to think through doing” to get the correct diagnosis. Abductive inferential path originates with an emotional reaction (discovery of the signs), step by step explanations are formed and it ends with another emotional reaction (diagnosis). Few bedside instruments are allowed to physicians to amplify their ability to search for signs. Stethoscope is an example. Similarities between ultrasound exploration and percussion can be found. Bedside ultrasonography can be considered an external amplifier of signs, a particular kind of percussion and represents a valid example of abductive manipulation. In this searching for signs doctors act like detectives and sometimes the discovering of a strategic, unsuspected sign during abductive manipulation could represent the key point for the correct diagnosis. This condition is called serendipity. Ultrasound is a powerful tool for detecting soft, hidden, unexpected and strategic signs.http://link.springer.com/article/10.1186/s40248-017-0098-zAbductionChest ultrasonographyDiagnostic approachLungSemioticsUltrasound |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gino Soldati Andrea Smargiassi Alberto A. Mariani Riccardo Inchingolo |
spellingShingle |
Gino Soldati Andrea Smargiassi Alberto A. Mariani Riccardo Inchingolo Novel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics? Multidisciplinary Respiratory Medicine Abduction Chest ultrasonography Diagnostic approach Lung Semiotics Ultrasound |
author_facet |
Gino Soldati Andrea Smargiassi Alberto A. Mariani Riccardo Inchingolo |
author_sort |
Gino Soldati |
title |
Novel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics? |
title_short |
Novel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics? |
title_full |
Novel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics? |
title_fullStr |
Novel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics? |
title_full_unstemmed |
Novel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics? |
title_sort |
novel aspects in diagnostic approach to respiratory patients: is it the time for a new semiotics? |
publisher |
PAGEPress Publications |
series |
Multidisciplinary Respiratory Medicine |
issn |
2049-6958 |
publishDate |
2017-06-01 |
description |
Abstract Medical approach to patients is a fundamental step to get the correct diagnosis. The aim of this paper is to analyze some aspects of the reasoning process inherent in medical diagnosis in our era. Pathologic signs (anamnestic data, symptoms, semiotics, laboratory and strumental findings) represent informative phenomena to be integrated for inferring a diagnosis. Thus, diagnosis begins with “signs” and finishes in a probability of disease. The abductive reasoning process is the generation of a hypothesis to explain one or more observations (signs) in order to decide between alternative explanations searching the best one. This process is iterative during the diagnostic activity while collecting further observations and it could be creative generating new knowledge about what has not been experienced before. In the clinical setting the abductive process is not only theoretical, conversely the physical exploitation of the patient (palpation, percussion, auscultation) is always crucial. Through this manipulative abduction, new and still unexpressed information is discovered and evaluated and physicians are able “to think through doing” to get the correct diagnosis. Abductive inferential path originates with an emotional reaction (discovery of the signs), step by step explanations are formed and it ends with another emotional reaction (diagnosis). Few bedside instruments are allowed to physicians to amplify their ability to search for signs. Stethoscope is an example. Similarities between ultrasound exploration and percussion can be found. Bedside ultrasonography can be considered an external amplifier of signs, a particular kind of percussion and represents a valid example of abductive manipulation. In this searching for signs doctors act like detectives and sometimes the discovering of a strategic, unsuspected sign during abductive manipulation could represent the key point for the correct diagnosis. This condition is called serendipity. Ultrasound is a powerful tool for detecting soft, hidden, unexpected and strategic signs. |
topic |
Abduction Chest ultrasonography Diagnostic approach Lung Semiotics Ultrasound |
url |
http://link.springer.com/article/10.1186/s40248-017-0098-z |
work_keys_str_mv |
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