Diagnostic judgment

Brehmer, B. (1981), Models of Diagnostic Judgment, in Hurmm Detection ami Diagnosis of System Failures, J. Rasmussen and W. Rouse, Eds., Plenum Press, New York. 

All the themes which have been mentioned in the previous chapters are more or less accounted for in the safety elements of the SDQ perceptional processes, work execution, risk-taking behavior, contextual conditions. Diagnostic judgments are given on 5-point and yes/no rating scales. In its present (2nd) version, the SDQ contains 8 chapters with a total of 165 safety elements (Tab. 7.1). 

Visible symptoms are useful in characterizing the response of vegetation to a variety of stresses, including air pollution/ Similar symptoms, induced by different stresses, have been well described and may confuse the diagnosis. On the basis of studies to date, diagnostic techniques that use indicators other than visible injury (e.g., respiration) are less reliable than the subjective judgment of an experienced observer. Thus, it is important that researchers become familiar with injury symptoms caused by oxidants and those caused by other stresses. This section briefly describes the injury symptoms used for diagnostic purposes. 

Fortunately, there are already some general practitioners and doctors who take MCS patients very seriously and cooperate in trying to improve their situation, but the majority of medical doctors have not been trained in environmental illnesses and often do not understand MCS very well. When visiting specialists within the mainstream medical establishment, many MCS patients are met with disbelief or the judgment that it s all in your head, since these specialists cannot find a clear explanation for their symptoms using conventional diagnostic models. 

The challenge in diagnosing CHR is that many of the presenting symptoms are nonspecific. Yet, studies have shown that there were dramatic differences in BNP of patients with dyspnea caused by cardiac failure (mean of 1076 ng/L) versus BNP in patients with dyspnea caused by noncardiac etiologies (mean of 86 ng/L).ROC curves have shown that BNP had better overall accuracy than the clinician s judgment (AUC 0.97 versus 0.88), with similar findings observed for NT-proBNP.It is important to remember that BNP is not a stand-alone diagnostic test it must be used and... 

In the treatment of the sick person, the doctor must be free to use a new diagnostic and therapeutic measure, if in his or her judgment it offers hope of saving life, reestablishing health, or alleviating suffering. 

As we said before, in SAMPLE the diagnostic tutoring teaching strategy used in SEDAF is abandoned and replaced with a less judgmental and a more collaborative relationship between the student and the system. 

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