Structured Solutions For Medical History Taking: A Historical Review

Abstract

Introduction: History taking (HT) is the basis for medical practice. Although its format lacks a standard, many HT Instruments (HTI) were developed, applied, and automated throughout history. Objective: To build a history line about HTI development, its pros and cons. Method: We accessed medline and lilacs database through the bvs search engine, using HT equivalents in english, portuguese, french, spanish, and german. Original papers and reviews about HTI aiming general practice were selected, and their content comprehensively analyzed and discussed, following PRISMA guidelines. Results: From 24904 initial entries about HT since 1900, 105 were selected for analysis. First HTI was identified before the 1st World War, mainly as mental screening tools. Later, other general practices HTI were developed, integrating statistical and branching reasoning. Two advantages were consistently reported about clinician time saving and improvement on information gathering. However, their use did not become widespread, restricted to research scenarios and specific guidelines for clinical intervention. Conclusions: HTI benefits may result from ht systematization, and it is not clear if clinical time-saving results in economic and quality of care improvement. However, the systematization of HT and the use of computational processing power may help medical practice and should not be overlooked. Better comprehension of the diagnostic HT clinical act will help comprehend how HTI may be useful for clinical practice, reasoning and doctor patient relationship.