ABSTRACT

INTRODUCTION The patient-physician encounter is an inquiry designed to disclose and test disease hypotheses. Physicians detect "cues" early in a patient interview and use them to generate predictions about a disease presence or state. They then ask questions to test the likelihood of hypothesized disease(s) and answers modify perceived proba­ bility. This process continues until a reasonable list of potential problems, a differential diagnosis, is shaped and decisions become more explicit. Physicians rely on their own experience, skill, and knowledge base to assign values to the presence or absence of key clinical features.