Diagnosis is a probabilistic estimate of disease. a dynamic approach to diminish resource overuse

© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.Clinical reasoning (mostly diagnostic reasoning) is made of two sequential steps: firstly, problem-solving - estimating disease probabilities through information from the physical exam and sequential tests, providing new information to refine the probability that the patient has a specific disease. Secondly, decision-analysis - a method that formally integrates the evidence regarding the beneficial and harmful effects of treatment options, considering the patient´s values regarding those effects, requiring knowledge of treatment effects, and whether the benefits outweigh risks and costs. This approach is duly called evidence-based diagnosis.