The Diagnostic Process

Question 1

What are the 2 models of diagnostic reasoning

Answer 1

Non-Analytical Model (fast system)
Analytical Model (slow system)

Question 2

What is VINDICATES and what is it used for?

Answer 2

VINDICATES is an acronym used to refine your differential list.
V = Vascular
I -Infection/Inflammation/Autoimmune
N = Neoplasms
D = Drugs
I = Iatrogenic
C = Congenital/Developmental/Inherited
A = Anatomic
T = Trauma
E = Environmental Exposure/Endocrine/Metabolic

Question 3

What is epidemiology?

Answer 3

How often disease occurs in different groups and why.

Question 4

What is validity?

Answer 4

Does the test accurately identify whether a patient has a disease?

Question 5

What is sensitivity?

Answer 5

True POSITIVE. The probability that a person with a disease has a POSITIVE test.

Question 6

What does SnNOUT stand for?

Answer 6

A Sensitive test with a Negative results rules OUT disease.

A highly sensitive test means that there are few false negative results, and thus fewer cases of disease are missed.

Question 7

What is specificity?

Answer 7

True NEGATIVE. The probability that a non-diseased person has a NEGATIVE test.

Question 8

What does SpPIN stand for?

Answer 8

A SPecific test with a Positive results rules IN disease.

Question 9

What is a positive predictive value (PPV)?

Answer 9

The probability that a person with a POSITIVE test has the disease.

Question 10

What is a negative predictive value (NPV)?

Answer 10

The probability that a person with a NEGATIVE test does not have the disease.

Question 11

What is a likelihood ratio (LR)?

Answer 11

The probability of obtaining a given test result in a disease patient divided by the probability of obtaining a given test result in a non-diseased patient.

Question 12

Sensitivity or Specificity?
I know my patient has the disease. What is the chance that the test will show that my patient has it?

Answer 12

Sensitivity (true positive)

Question 13

Sensitivity or Specificity?
I know my patient does not have the disease. What is the chance that the test will show that my patient doesn’t have it?

Answer 13

Specificity (true negative)

Question 14

Positive Predictive Value (PPV) or Negative Predictive Value (NPV)?

I just got a positive test result back on my patient. What is the chance that my patient has the disease?

Answer 14

Positive Predictive Value (PPV)

Question 15

Positive Predictive Value (PPV) or Negative Predictive Value (NPV)?

I just got a negative test result back on my patient. What is the chance that my patient doesn’t have the disease?

Answer 15

Negative Predictive Value (NPV)