Medical Testing Decisions

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By nclexnursing

Medical testing decisions because numerous diseases can exhibit the same symptoms, it can be difficult for doctors and other primary care providers to figure out what’s causing them. Doctors begin by interviewing and evaluating the patient to acquire basic information. This is frequently all that is required to make a diagnosis. The fundamental information, at the very least, narrows the range of options and reduces the number of tests required. Ordering tests without first cutting down the list of possibilities can be costly, raise the likelihood of a misdiagnosis, and put patients in danger.

Gathering Basic Medical Information

This procedure aids in determining which diseases are most likely to be the source of the patient’s symptoms and which diseases should be ruled out.

Medical history

Doctors question people about their symptoms, other known health conditions, and previous health-related events as part of their medical history.

It’s crucial to know the specifics of people’s symptoms (such as how long they’ve been there, whether they’re consistent or come and go, and what relieves them). Doctors sometimes inquire about other symptoms that patients may not have considered. People with a cough, for example, are frequently asked if they also have a runny nose and a painful throat (which might suggest the cause of the cough is a viral upper respiratory infection).

Various characteristics of a person’s life or history can increase their chances of contracting various diseases. Persons who smoke, for example, have a higher risk of lung cancer than nonsmokers; people with diabetes have a higher risk of heart disease than those who do not have diabetes, and the risk of various diseases varies depending on ethnicity. As a result, queries about the medical history are frequently asked.

  • Current and past illnesses
  • Regular medications
  • Diseases that run in the family
  • History of travel overseas
  • Sexual practices
  • Use of cigarettes, alcohol, and/or recreational drugs
  • Occupation and hobbies

Doctors evaluate a person’s medical history when determining the possible causes of symptoms.

  • Age
  • Gender
  • Ethnicity

Physical examination

Doctors do a physical examination after speaking with the patient. Physical indications, whether present or absent, can assist limit down the list of diseases that could be causing a person’s symptoms.

Doctors examine people’s vital signs (heart rate, breathing rate, and blood pressure) as well as their overall appearance for indicators of sickness. Symptoms of the disease include feeling weak, weary, pale, and sweating, as well as having trouble breathing. Doctors then check various regions of the body, typically starting at the head and working their way down to the feet. Doctors pay special attention to the area of the body where the person’s symptoms are located, but they also examine for abnormalities in other locations.

Diagnostic tests

Diagnostic tests are used to determine the cause of a person’s symptoms. Doctors and other primary care providers consider the following factors while selecting tests:

  • Which diseases are most likely
  • Risks of the tests
  • Costs of the tests
  • The ability of the person to access and undergo the test
  • Accuracy of the tests
  • The seriousness of the person’s symptoms and general condition
  • The person’s preferences

However, not all tests have all of these beneficial characteristics. Doctors must choose the optimal tests for each patient based on their experience and education.

There are a variety of reasons why a patient may not be able to receive the doctor’s initial choice of disease test. Here are a few examples of what I’m talking about:

People who suffer from claustrophobia may refuse to have their magnetic resonance imaging (MRI) tests done.

MRI may not be possible for those who have certain types of mechanical heart pacemakers.

People with renal disease or allergies may be unable to receive contrast agent injections during certain computed tomography (CT) or magnetic resonance imaging (MRI) exams.

People who reside in rural areas may be unable to go to centers that offer certain examinations.

The expense of the testing may be prohibitive for some people.

In these circumstances, the doctor would suggest the next most appropriate test.

The severity of the symptoms and a person’s overall health can influence which diagnostic tests are used:

A doctor may order fewer tests if the symptoms are minor and not likely to be caused by a dangerous condition. Additional tests can be done later if necessary.
A doctor may conduct multiple tests at once to determine the diagnosis of a serious sickness or symptoms that point to a disease that could cause immediate harm. A doctor may even urge hospitalization if time is of the essence.

When less intrusive tests (such as a blood test or a CT scan) fail to uncover the source of the condition, a doctor may suggest a more invasive test (typically a biopsy or surgical operation). People should understand the risks and benefits of the planned procedure before agreeing to it, or giving informed consent, in such instances.

In some situations, a doctor may additionally inquire about how vital it is for them to know if they have a condition or to receive treatment for that sickness if they do.

Screening tests

Screening tests are used to detect diseases in patients who are asymptomatic. Most primary care physicians, for example, recommend that everyone over the age of 45 have a colonoscopy to check for colon cancer, even if they have no symptoms and are in good health. Screening is founded on the logical assumption that if an illness is detected and treated early on, the prognosis would be better. This concept, while logical, is not always correct. In some diseases, such as testicular cancer and ovarian cancer, there appears to be no difference in result between those whose disease is found by screening and those who are diagnosed after the first symptoms occur.

Another issue with screening tests is that the results almost always need to be confirmed by a more conclusive test. Women who receive mammography with abnormal results, for example, may require a breast biopsy. Such conclusive tests are frequently invasive, painful, and even deadly. A lung biopsy, for example, can result in a collapsed lung. Because screening test results can be abnormal in people who don’t have a disease (which is common because no test is 100 percent accurate), some people are subjected to unneeded procedures that could harm them.

As a result, clinicians only advocate screening tests for disorders where it has been proved that doing so improves outcomes.

Clinical trials are required to determine which screening tests are beneficial and which individuals should have them performed. Despite these reservations, it is obvious that screening saves lives for some conditions, such as high blood pressure and cervical cancer. Screening tests must be useful in order to be effective.

  • Be accurate
  • Be relatively inexpensive
  • Pose little risk
  • Cause little or no discomfort
  • Improve outcomes

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Classification tests

Some tests are used to classify and quantify the severity of an already identified condition. The findings could lead to more targeted and effective treatment options. Additional tests are performed when a breast cancer diagnosis is confirmed, for example, to determine the kind of breast cancer and whether or not cancer has spread.

Monitoring tests

Tests are also used to track the progression of an illness over time, and to see how well it responds to treatment. People who take thyroid hormone to treat hypothyroidism, for example, have blood tests done on a regular basis to see if the hormone dose they’re taking is the right one for them. The frequency of such testing is determined by the individual’s circumstances.

Medical Test Results Interpretation

Tests aren’t always accurate.

In those who have the disease being tested for, the results can sometimes be normal. Tests can produce false-negative results, in other words. In persons who do not have the disease being tested for, the results can be abnormal. Tests can produce false-positive results, in other words.

The sensitivity and specificity of a diagnostic test are two highly essential characteristics:

Sensitivity: The chance of aberrant results in those who have the condition being tested for.

Specificity: The possibility that results in people who do not have the condition will be normal.

Only well-designed studies can determine both of these crucial qualities.

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