Abstract

ANDRADE-CASTELLANOS, Carlos A. Pivotal diagnosis: an approach. Med. interna Méx. [online]. 2019, vol.35, n.1, pp.144-149. ISSN 0186-4866.  https://doi.org/10.24245/mim.v35i1.2317.

The general internist uses various strategies in his/her daily diagnostic process. A structured method is required to provide adequate reasoning with the information gathered. Knowledge, intelligence and memory are of utmost importance for constructing clinical reasoning. The information gathered from the clinical history is indispensable to make right clinical decisions; this requires a good dose of intelligence -to obtain and interpret the relevant data- along with a good memory -to remember the stored information-; both are essential to acquire expert clinical judgment. A pivot diagnostic strategy might provide a guide for clinical reasoning and act as a cognitive aid. We propose here an approach to pivotal diagnosis. This strategy is especially useful for less clinically experienced doctors who are less likely to generate appropriate differential diagnosis.

Keywords : Reasoning; Intelligence; Memory; Differential diagnosis.