Diagnosing Diagnosis: a multidisciplinary perspective (360G-Wellcome-208213_Z_17_Z)

Diagnosis is at the heart of the medical encounter, but many features of making, communicating and recording a diagnosis remain poorly understood and little researched. Without greater understanding, we cannot provide adequate guidance to clinicians about what information to share with patients or adequate advice to patients about what questions to ask, and policy incentives to address problems with ‘overdiagnosis’ or ‘misdiagnosis’ are at risk of unintended consequences. Key goals: To examine the process of making, communicating and recording a medical (differential) diagnosis in the acute care setting; To examine institutional influences on the diagnostic process; To examine ethical and philosophical influences on making and communicating diagnoses; To establish an empirically based, ethically grounded framework for making, communicating and recording a diagnosis to improve patient outcomes on both individual and societal levels. Methodology: Qualitative methods including ethnography and interviews will be combined with medical records analysis and quantification of the reach and permanence of diagnostic labelling between health care settings. Integrated with this empirical work, ethical analysis will explore how the interplay between responsibility, uncertainty and trust affects the process and communication of making a medical diagnosis. This is emphatically multidisciplinary research which benefits from combining different perspectives and methodologies.