BMJ  2006;332:646 (18 March), doi:10.1136/bmj.332.7542.646

Commentary

Pattern recognition versus bayesian approach for diagnosis in primary care

¹ Bicester Health Centre, Bicester, Oxon OX26 6AT

The first 150 words of the full text of this article appear below.

Our first thought on reading this case was, "That's just too unusual. We can't possibly send every 28 year old woman with a bit of chest pain off for echocardiography."¹ In thinking that, we were using pattern recognition—a common approach to clinical diagnosis. We assumed that a young woman could not have note-worthy ischaemic heart disease.

But is there more to this case? If we were to substitute a 28 year old woman for a 50 year old man in the same scenario, most clinicians would recognise a familiar clinical pattern and put ischaemic heart disease high on the list of possible causes of "exertional chest pain relieved by rest." Clinicians interpret symptoms in the light of what they believe are the possible diagnoses for the patient sitting in front of them. Thus ischaemic heart disease is high on the list for older men and low on the list for . . . [Full text of this article]

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