Exploring Symptoms E-Book

John Frain

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 832

Veröffentlichungsjahr: 2025

Beschreibung

Understand the relationship between disease and description with this invaluable guide

Correctly interpreting patient symptoms is one of the most critical components of medical diagnosis and treatment. Though each instance of any given disease will share features with others, each patient’s experience is unique, and assessment of their condition depends on taking and interpreting an individual patient’s history. Correct diagnosis and treatment decisions rely on a sound, evidence-based approach to this crucial clinical interaction.

Exploring Symptoms - An Evidence-based Approach to the Patient History offers a rigorous analysis of the complex relationship between symptoms and patient communication. Carefully connecting basic sciences such as anatomy and physiology with the development of symptoms in each body system, this book surveys evidence for how patients tend to experience and describe symptoms and how these descriptions can shape diagnosis and treatment. It’s a must-have volume for students and clinicians looking to concretely improve patient outcomes.

Exploring Symptoms - An Evidence-based Approach to the Patient History readers will also find:

• Detailed discussion of patient thresholds for presenting symptoms to healthcare professionals
• Analysis of individual symptom epidemiology and its general expression at both the patient and population level
• An inclusive approach with concrete advice for addressing the needs of a diverse patient body

Exploring Symptoms - An Evidence-based Approach to the Patient History is ideal for undergraduate and postgraduate students, as well as healthcare educators and postgraduate-allied health professionals. It is also a useful tool for early-years practitioners and general practitioners.

Leseprobe

Exploring Symptoms – An Evidence‐based Approach to the Patient History

John Frain

University of Nottingham, UK

This edition first published 2025© 2025 John Frain

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Library of Congress Cataloging‐in‐Publication DataNames: Frain, John (John Patrick James), author.Title: Exploring symptoms – An Evidence‐based Approach to the Patient History / John Frain.Description: Hoboken, NJ : Wiley‐Blackwell, 2025. | Includes bibliographical references and index.Identifiers: LCCN 2024025374 (print) | LCCN 2024025375 (ebook) | ISBN 9781394218813 (paperback) | ISBN 9781394218820 (adobe pdf) | ISBN 9781394218837 (epub)Subjects: MESH: Signs and Symptoms | Medical History Taking | Patient‐Centered CareClassification: LCC RC65 (print) | LCC RC65 (ebook) | NLM WB 143 | DDC 616.07/51–dc23/eng/20240725LC record available at https://lccn.loc.gov/2024025374LC ebook record available at https://lccn.loc.gov/2024025375

Cover Design: WileyCover Images: © Rawpixel.com/Adobe Stock, © Joos Mind/Getty Images, © RainStar/Getty Images, Courtesy of John Frain

Preface

Patients present with symptoms not diseases. They rely on healthcare professionals to accurately interpret these symptoms. A patient who attends their doctor is saying: ‘I've noticed my anatomy and physiology are changing’. Can you tell me: is this normal change as I get older? Or am I developing a disease? If it is a disease: will it get better, and will I return to normal? Or will it continue and change my health and level of function? Will it shorten my life?

Answering these questions requires good communication but also accurate interpretation of the patient's description based on understanding of what is being described. Exploring Symptoms describes the connection between the underlying science of symptoms and the words used by patients to describe them. Though many patients may have a particular disease, each person's experience and description of it is unique to them. Nonetheless, connecting science, patients words, and studies of how symptoms are presented in disease facilitates clinical reasoning and diagnostic accuracy. It is safer for patients and more professionally satisfying for clinicians. Importantly, it may lead to more judicious use of finite resources with more appropriate choice of limited diagnostic technologies.

Despite technological advances in medicine and particularly in diagnostics, the patient history remains responsible for approximately 80% of diagnoses. Even where examination, blood tests and imaging are undertaken, they can only be accurately interpreted by reference to the patient's symptoms. Rightly, we emphasise the evidence‐base to establish new investigations and treatments not least on the grounds of patient safety. However, the history, our most important tool, remains without a firmly established and widely known evidence‐base so far as its content is concerned. Understanding the patient's symptoms is crucial to modern medicine for diagnostic accuracy, patient safety, and satisfaction and for good resource management in finite health services.

I have tried to ensure this work is representative of those who too often feel excluded from heath care and who suffer discrimination from services through no fault of their own. I could not include everything about all groups or individuals, but this book is dedicated to everyone. I hope it will contribute to improving care for all of us.

I thank Dr. Anna Frain for her reading and re‐reading of the chapters which has helped to refine and clarify the text and for all the support she has given over the past year I have been writing this book. Dr. Jo Butler of www.medical‐artist.com has provided some wonderful anatomical illustrations to help connect the science to the patient experience. Thank you also to Fozia Mushtaq, Prathishta Gnanaratnasingham, Isabel and Leo Ashford, Leonardo Jackson and Dr. Magdy Abdalla all from the University of Nottingham, UK for their contribution to Chapters 1, 5 and 15.

Abbreviations

ACS

acute coronary syndrome

ADL

activity of daily living

aF

birth‐assigned female

AIDS

acquired immune deficiency syndrome

aM

birth assigned male

AOR

adjusted odds ratio

ASDR

age‐standardised death rates

ASIR

age‐standardised incidence rate

ASMR

age standardised mortality ratio

ASR

age standardised rate

AUC

area under the curve

BPD

borderline personality disorder

BPH

benign prostatic hypertrophy

CFS

chronic fatigue syndrome

CGA

comprehensive geriatric assessment

CI

confidence interval

CNS

central nervous system

COPD

chronic obstructive pulmonary disease

CRC

colorectal cancer

CVD

cardiovascular disease

DALY

disability adjusted life year

DGBI

disorders of gut‐brain axis

DIMS

disorders of initiating and maintaining sleep

DLQI

dermatology life quality index

DOS

disorders of excessive somnolence

DSM V

diagnostic and statistical manual of mental disorders

EASI

eczema area and severity index

ED

erectile dysfunction

EDC

endocrine disrupting chemicals

EMBID

endocrine, metabolic, blood and immune disorders

ENS

enteric nervous system

FND

functional neurological disorder

FSH

follicle stimulating hormone

FTD

formal thought disorder

FUO

fever of unknown origin

GCS

Glasgow coma scale

GD

gender dysphoria

GI

gastrointestinal

GP

general practitioner

GTS

generalised tonic‐clonic seizures

GUM

genitourinary medicine

HCl

hydrochloric acid

HIV

human immunodeficiency virus

HMB

heavy menstrual bleeding

HPA

hypothalamo‐pituitary‐adrenal axis

HRT

hormone replacement therapy

HVS

hyperventilation syndrome

IADL

instrumental activities of daily living

IBD

inflammatory bowel disease i.e. ulcerative colitis and Crohn's

IBS

irritable bowel syndrome

IPSS

international prostate symptom score

LBP

low back pain

LGBTQ+

lesbian, gay, non‐binary, transgender, queer +

LR

likelihood ratio

LUTS

lower urinary tract symptoms

ME

myalgic encephalitis

MRI

magnetic resonance imaging

MSK

musculoskeletal

MSM

men who have sex with men

NCCP

non‐cardiac chest pain

NEWS

national early warning score

NSAID's

non‐steroidal anti‐inflammatory drugs

NSTEMI

non‐ST elevation myocardial infarction

OA

osteoarthritis

OAB

overactive bladder

OR

odds ratio

PASI

psoriasis area and severity index

PNES

psychogenic non‐epileptic seizures

PUD

peptic ulcer disease

PVB

premature ventricular beat

RA

rheumatoid arthritis

RA‐ILD

rheumatoid arthritis‐interstitial lung disease

RR

risk ratio

SAH

subarachnoid haemorrhage

SDI

socio‐demographic index

SGM

sexual and gender minority

SIBO

small intestinal bacterial overgrowth

SIRS

systemic inflammatory response syndrome

SM

sexual minorities

SNOOP4

mnemonic for assessment of headache:

S

ystemic symptoms

N

eurological symptoms

O

nset sudden

O

nset after age 50

P

rogressive

P

recipitated by Valsalva

P

ostural relationship

P

apilloedema

SOC

skin of colour

SOCRATES

S

ite

O

nset

C

haracter

R

adiation

A

lleviating factors

T

ime course

E

xacerbating factors

S

everity

SAH

subarachnoid haemorrhage

STD

sexually transmitted disease

STI

sexually transmitted infection

TIA

transient ischaemic attack

UI

uncertainty interval

UK

United Kingdom of Great Britain and Northern Ireland

US

United States of America

UTI

urinary tract infection

WHO

World Health Organisation

WSW

women who have sex with women

YLD

years lost to disability

YLL

years of life lost