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other diseases possibly accounting for a patient's illness. The differential diagnosis of rhinitis (a
runny nose) includes allergic rhinitis (hayfever), the abuse of nasal decongestants and, of course,
the common cold.
In medicine, differential diagnosis (sometimes abbreviated DDx, ddx, or ΔΔ) is the systematic
method healthcare providers use to identify the disease causing a patient's symptoms. In other
words, part of diagnosis is attempting to narrow down the list of possible diagnoses until one
emerges as the best. The term differential evolves from the word differences. The concept of
differential diagnosis involves observing and discovering signs and symptoms, then progressively
considering the most likely illnesses, then continuously narrowing down the possible diagnoses,
eliminating one after another, until one is left with only one specific diagnosis for the patient's
signs and symptoms.
Differential Diagnosis is the process whereby a given condition or circumstance, called the
presenting problem or chief complaint, is examined in terms of underlying causal factors and
concurrent phenomena as discerned by appropriate disciplinary perspectives and according to
several theoretical paradigms or frames of reference, and compared to known categories of
pathology or exceptionality. Differential diagnosis allows the physician to:
If the patient's condition does not improve, the diagnosis must be reassessed. The method of
differential diagnosis was first suggested for use in the diagnosis of mental disorders by Emil
Kraepelin. It is more systematic than the old-fashioned method of diagnosis by gestalt
(impression).[citation needed]
The method of differential diagnosis is based on the idea that you begin by first considering the
statistically more probable diagnoses. Medical students are taught the adage, "When you hear
hoof beats, think horses, not zebras." It means that only after more probable diagnoses are ruled
out do the somewhat less likely ones considered, and so forth. It used to be that doctors ordered
only particular blood tests, but now the standard is a full blood chemistry profile which can speed
up the process of diagnosis as well as uncover sub-clinical conditions. With the advent of better
radiological studies like MRI and the wider use of nuclear medicine, it has become more likely
that there will be unexpected findings that will be further studied, despite the fact that the findings
will not be supported by further investigation. They are a valuable tool, but not infallible. It still
often takes a physicians or medical team to track down either a more common illness with a rare
presentation or a rare illness with symptoms suggestive of many other conditions. Sometimes a
definitive diagnosis might take years.
The term differential diagnosis also refers simply to a list of the most common causes of a
given symptom, or a list of disorders similar to a given disorder.
In medicine today, doctors search for methods of predicting how a patient (given their condition)
may respond to treatment. Symptoms and tests may indicate favorable treatment with standard
therapies. Likewise, a number of symptoms, health factors, and tests may indicate a less
favorable treatment result with standard treatment - this may indicate that a more aggressive
treatment plan may be desired.
Two areas where this type of prognosis prediction, or the use of prognostic indicators, is with
Hodgkin's lymphoma and Non-Hodgkin lymphoma. Specifically with Non-Hodgkin lymphoma,
physicians have developed the International Prognostic Index to predict patient outcome.
Prognostic scoring is also used for other cancer outcome predictions. A Manchester score is an
indicator of prognosis in small cell lung cancer.
Other medical areas prognostic indicators are used is in Drug-Induced Liver Injury (DILI) (Hy's
Law) and use of an exercise stress test as a prognostic indicator after myocardial infarction.