Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

An exposé on Big Pharma and the American healthcare system’s zeal for excessive medical testing, from a nationally recognized expert More screening doesn’t lead to better health—but can turn healthy people into patients. Going against the conventional wisdom reinforced by the medical establishment and Big Pharma that more screening is the best preventative medicine, Dr. Gilbert Welch builds a compelling counterargument that what we need are fewer, not more, diagnoses. Documenting the excesses of American medical practice that labels far too many of us as sick, Welch examines the social, ethical, and economic ramifications of a health-care system that unnecessarily diagnoses and treats patients, most of whom will not benefit from treatment, might be harmed by it, and would arguably be better off without screening. Drawing on 25 years of medical practice and research on the effects of medical testing, Welch explains in a straightforward, jargon-free style how the cutoffs for treating a person with “abnormal” test results have been drastically lowered just when technological advances have allowed us to see more and more “abnormalities,” many of which will pose fewer health complications than the procedures that ostensibly cure them. Citing studies that show that 10% of 2,000 healthy people were found to have had silent strokes, and that well over half of men over age sixty have traces of prostate cancer but no impairment, Welch reveals overdiagnosis to be rampant for numerous conditions and diseases, including diabetes, high cholesterol, osteoporosis, gallstones, abdominal aortic aneuryisms, blood clots, as well as skin, prostate, breast, and lung cancers. With genetic and prenatal screening now common, patients are being diagnosed not with disease but with “pre-disease” or for being at “high risk” of developing disease. Revealing the economic and medical forces that contribute to overdiagnosis, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, excessive worry, and exorbitant costs, all while maintaining a balanced view of both the potential benefits and harms of diagnosis. Drawing on data, clinical studies, and anecdotes from his own practice, Welch builds a solid, accessible case against the belief that more screening always improves health care.

Rare diseases collectively affect millions of Americans of all ages, but developing drugs and medical devices to prevent, diagnose, and treat these conditions is challenging. The Institute of Medicine (IOM) recommends implementing an integrated national strategy to promote rare diseases research and product development.

In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients.

This second edition of The Physician's Guide provides paediatricians and other physicians with a unique aid to help them select the correct diagnosis from a bewildering array of complex clinical and laboratory data. Delay and mistakes in the diagnosis of inherited metabolic diseases may have devastating consequences. The guide, which includes a CD-ROM, describes 298 disorders which have been grouped into 35 chapters according to the type of condition. Within each group of disorders, chapters provide tables of pertinent clinical findings as well as reference and pathological values for crucial metabolites. Relevant metabolic pathways and diagnostic flow charts are included. There are three indices to make the book as user-friendly as possible.

Intended for family physicians and others in primary care delivery. Compatible with International classification of diseases, 9th ed.

Comprehensive and up to date, the Second Edition of Diagnostic Pathology: Infectious Disease, by Dr. Richard Kradin, is an invaluable tool for the accurate diagnosis of any infectious disease?from the common to the most challenging. The organ-based format makes it an especially useful tool for surgical pathologists' daily diagnostic and management issues. High-quality, full-color illustrations and differential diagnosis tables accompany each lesion, clearly depicting how to recognize the morphology of organisms and the spectrum of histological responses that they may cause. - Addresses the most difficult diagnostic issues that practicing or trainee surgical pathologists face when handling infectious disease tissue specimens. - Highlights morphological characteristics and landmarks of tissue samples for easy access to information necessary for signing out a specimen. - Emphasizes the host responses critical in differential diagnosis to serve as a second opinion when non-infectious diagnoses mimic and confound the diagnosis of infection. - Completely revised with the latest diagnostic support and hot topics in the field: - A new chapter on novel techniques in microbiology - A new chapter on eye infections - New coverage of immunohistochemical staining and other molecular diagnostic techniques - New discussions of human papillomavirus, a critical tool in predictive cancer screening - New information on infections in the immunocompromised host and related special considerations - Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, images, videos (including video updates), glossary, and references from the book on a variety of devices.

Part of the highly regarded Diagnostic Pathology series and written by Danny A. Milner, Jr., MD, this updated volume covers all aspects of infectious disease pathology, including anatomic manifestations and how to ensure a complete and accurate sign out at the microscope. Concise, focused chapters, supported by thousands of high-quality images, make this second edition an excellent point-of-care resource for pathologists at all levels of experience and training—both as a quick reference and as an efficient review to improve knowledge and skills. - Provides essential information by organism type (virus, bacteria, fungi, and parasite), further divided by those organisms that can be diagnosed on histological appearance, to help you quickly and accurately identify what you see at the microscope - Contains new information on Zika virus, rhinosporidiosis, coenurosis, and more, as well as new material on approaching emerging infections with a biosafety/notification focus - Features additional figures and diagrams to help with rare organism identification, and new details on an algorithmic approach to identification - Includes coverage of iatrogenic immunosuppression and organism correlations, explanatory life cycles with emphasis on when pathology occurs, updated diagnostics sections on molecular testing, and diagrammatic correlations of viruses with accompanying electron microscope imagery - Contains time-saving features such as bulleted text, annotated images, reference tables, and more - Offers Key Facts that highlight the quick criteria needed for diagnosis or evaluation at the time of a procedure - Explains when and when not to use molecular diagnostics, and discusses histological limitations and how to address them at sign out