Can we “suspect” a diagnosis “in advance”?
Could we make a diagnosis “before” the devastating consequences of a subarachnoid hemorrhage? Can we make an early diagnosis of cancer only using the symptoms and signs of a person? The NHS in United Kingdom has established a four weeks period of time after a suspicion of cancer for a definitive diagnosis, but how a doctor can get this “suspicion”?
We believe that this situation that we call “prediagnosis” can be achieved through a combination of intuition, professionalism, clinical prediction rules, patient engagement, clinical experience and a proper evaluation of the signs and symptoms of the patient. This concept overlap with others well defined such as “early diagnosis” or ” diagnostic delay” , two definitions what are defined based on the outcome. Prediagnosis in summary try to put a name to this period of time where we can act in a prospective way to avoid an important harm to the patient. In a first approach we could expose the different components of this concept to improve the diagnostic process.
|Intuition||To be aware. Improve clinical reasoning||Increase sensitivity|
|Professionalism||Follow clinical method||Better detection|
|Clinical prediction rules||Define variables with statistical significance||Select a population for more testing|
|Patient engagement||Active participation||Broad diagnostic possibilities|
|Signs and symptoms||Establish a practical combination of data.||Better predictive value|