The clinical picture, creating diagnostic constructs, and causation

Abstract

The clinical picture is the doctor’s interpretation based on what has happened to the patient and symptoms, signs, and results of investigations that are available to her. It is created by the interaction of causative factors as well as multiple cultural, interactive, and individual factors. The doctor matches the patient’s clinical picture with the diagnostic construct and the most common elements of an attached clinical picture. Diagnostic constructs based on similarity with the clinical picture may have clinical utility by accumulating information about likely outcomes and responses to treatments. Diagnostic constructs based on common mechanisms (such as changes in structure or processes) and/or causes have greater scientific validity and allow more reliable diagnostic investigations and better prospects of developing superior treatments. Most medical conditions are caused by a combination of causative factors. Proving a factor is causative is complex. One of the best known methods is Austen Hill’s framework. Conditions occur due to combinations of causes, characteristics, and contexts.