Tuesday, August 4, 2015

Terminology Tuesday: differential diagnosis illustrated by House, MD


As patients we're often used to being given a diagnosis after checking labs and such. If you've ever gotten a copy of your medical records, you may see something listed as a differential diagnosis.


If you don't know the process of the differential diagnosis, this can be slightly alarming. Why is this not a firm diagnosis? What's going on?

The differential diagnosis is, really simply, the process of getting a diagnosis for a patient. Many books on being an engaged patient involve obtaining a differential diagnosis before you leave your appointment. In this case, the term is used as a possible or likely diagnosis that is not yet confirmed.

The process of getting a diagnosis through these means involves analyzing the symptoms to see what types of diseases or other issues could be causing them.

It's always nice when you can use House to illustrate things!
This can be illustrated by really most episodes of House. House and his team utilize a white board to list symptoms and brainstorm over what the issue could be. They then run tests based on this session to attempt finding the culprit or ruling out possible diagnoses.

One of the nice things about House is that it shows how the initial differential diagnosis may not be the official diagnosis at the end of the day. This can be due to doctor error, false test results, and even the patient withholding information.

There is a whole lot of math that can be done with this, too, in order to determine the odds or probabilities of certain diseases. I've never heard of or seen this happen, so I'm guessing this may be more used in med school than it is in the real world.


Once diagnostics like labs are run, you will likely wind up with a just plain regular diagnosis.

Hopefully it's not goats.

Some people don't ever get a firm diagnosis, so the differential diagnosis becomes very important to them. It's the closest thing to a label to their illnesses that they may have. This is very true for rare disease patients.

Others still don't have access to proper medical care and wind up with a self made differential diagnosis. This is especially true for mental health issues. I knew I had PTSD for a while here before I was diagnosed earlier this year - just like I knew I had fibro before it was officially diagnosed in 2012. Self-diagnosis can be a vital tool for many, as it was for me. I have one caveat - please never use WebMD to figure one out.




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