illness scripts. Flashcards
What does a disease illness script represent to a practitioner?
- representation of a condition in the mind of a practitioner.
- they vary between practitioners.
What components does an illness script include?
- epidemiology.
- time course.
- clinical presentation (signs and symptoms i.e. syndrome)
- mechanism/pathophysiology.
- some resources may recommend additional components.
What does epidemiology include?
- demographics (age, sex race, ethnicity, SES).
- Risk Factors (including pre-existing conditions).
- exposures (including travel, occupational, hobbies, sexual, drugs, medications, pets, and close contacts).
why is ethnicity included in epidemiology?
- it has been traditionally described this way in the literature, but categorizations may be misleading.
What does the time course include?
- Duration (hyperacute, subacute, chronic).
- persistence/ pattern- is it constant (stable and progressive) or is it episodic (waxing and waning/intermittent).
What is the clinical presentation?
- A summary of most signs and symptoms.
- can use classical presentation but note that these can be misleading.
what is comparing and contrasting?
- it is organized around a clinical or lab-based syndrome.
- we have disease illness scripts next to each other in adjacent columns or rows.
- we focus on the most relevant differences.
- typically includes 2-3 diseases.
- useful to guide readings; allows you to focus on what is important, i.e. what can be used in the illness script.
- useful for studying diseases.
What is the processing of patient illness scripts?
- emphasizing the most valuable evidence and emphasizing the less valuable evidence
- abstracting the patient’s concerns into medical language.
- finalizing the problem list in a way that can be compared with disease illness scripts.
why do we process the patient illness script?
- the diagnostic process is improved (efficiency and precision) with good problem representation.
What is a patient illness script?
- a concise representation of the patient’s concerns that allows matching with a disease illness script.
what components are included in a disease illness script?
epidemiology
time course
clinical presentation (syndrome statement).
other medical histories.
- this provides a strong foundation for good medical record keeping.
what does epidemiology include in the patient illness script?
-demographics ( age, sex, race/ethnicity, socioeconomic status and physical characteristics (obesity)).
- risk factors and other relevant items from past medical history.
- exposures: includes other people, occupational, hobbies, drugs and medications.
What does the time course include in the patient illness script?
Duration: hyperacute, acute, subacute, chronic.
persistence/pattern; constant (stable/progressive) episodic (waxing, waning, intermittent).
What is the clinical presentation of a patient illness script?
- Focus on the most important signs and symptoms.
what does the clinical presentation exclude in the patient illness script?
- elements already mentioned in previous sections.
- findings with little relevance.
- the past medical history that is unconnected to the chief complaint.
- previous diagnosis (unless they were clearly correct).
