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Physicians' Use of Objective Data in Clinical Diagnoses

Katharine O. Elsom, MD, MSAM; Johannes Ipsen, MD, MPH; Thomas W. Clark, MD; Linda Talerico; Hiroshi Yanagawa, MD
JAMA. 1967;201(7):519-526. doi:10.1001/jama.1967.03130070039010.
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How a physician makes a diagnosis, the objective values he employs, and the way he weighs these in relation to other factors has remained largely outside the province of research. With the rising demand for preventive medical services, and for the diagnosis of disease in early stages, there is need both to conserve the physician's time and to extend his efficiency. Suggestions1-4 have been made that a computer be used to screen well persons from the sick and also to assist in early diagnosis, thereby freeing the physician for more complicated decisionmaking. Such suggestions imply demarcations between "normal" and "diseased" states in objective data and also imply a knowledge of what factors a physician uses, and how he uses them, in arriving at a diagnosis. The standards now used for abnormality in objective data are based largely on experience with hospitalized patients and with young normal volunteer subjects. Whether


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