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m Generating diagnostic hypotheses: task, replaced: Health Technology Assessment (Winchester, England) → Health Technology Assessment
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Determining which pieces of information are most important to the next phase of the diagnostic process is of vital importance.<ref name=":1" /><ref>{{Cite journal |last1=Hegedus |first1=Eric J. |last2=Goode |first2=Adam P. |last3=Cook |first3=Chad E. |last4=Michener |first4=Lori |last5=Myer |first5=Cortney A. |last6=Myer |first6=Daniel M. |last7=Wright |first7=Alexis A. |date=November 2012 |title=Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests |url=https://pubmed.ncbi.nlm.nih.gov/22773322 |journal=British Journal of Sports Medicine |volume=46 |issue=14 |pages=964–978 |doi=10.1136/bjsports-2012-091066 |issn=1473-0480 |pmid=22773322|s2cid=2373599 }}</ref> It is during this stage that clinical bias like anchoring or premature closure may be introduced.<ref>{{Cite journal |last1=Saposnik |first1=Gustavo |last2=Redelmeier |first2=Donald |last3=Ruff |first3=Christian C. |last4=Tobler |first4=Philippe N. |date=2016-11-03 |title=Cognitive biases associated with medical decisions: a systematic review |journal=BMC Medical Informatics and Decision Making |volume=16 |issue=1 |pages=138 |doi=10.1186/s12911-016-0377-1 |issn=1472-6947 |pmc=5093937 |pmid=27809908}}</ref> Once key findings are determined, they are compared to profiles of possible diseases.  These profiles include findings that are typically associated with the disease and are based on the likelihood that someone with the disease has a particular symptom.  A list of potential diagnoses is termed the “differential diagnosis” for the patient and is typically ordered from most likely to least likely, with special attention given to those conditions that have dire consequences for the patient if they were missed.<ref>{{Cite journal |last1=Weingart |first1=C. |last2=Schneider |first2=H.-J. |last3=Sieber |first3=C. C. |date=September 2017 |title=[Syncope, falls and vertigo] |url=https://pubmed.ncbi.nlm.nih.gov/28717918 |journal=Der Internist |volume=58 |issue=9 |pages=916–924 |doi=10.1007/s00108-017-0292-2 |issn=1432-1289 |pmid=28717918}}</ref><ref>{{Cite journal |last1=Kwok |first1=Chun Shing |last2=Bennett |first2=Sadie |last3=Azam |first3=Ziyad |last4=Welsh |first4=Victoria |last5=Potluri |first5=Rahul |last6=Loke |first6=Yoon K. |last7=Mallen |first7=Christian D. |date=2021-09-01 |title=Misdiagnosis of Acute Myocardial Infarction: A Systematic Review of the Literature |url=https://pubmed.ncbi.nlm.nih.gov/33606411 |journal=Critical Pathways in Cardiology |volume=20 |issue=3 |pages=155–162 |doi=10.1097/HPC.0000000000000256 |issn=1535-2811 |pmid=33606411|s2cid=231961318 }}</ref> Epidemiology and endemic conditions are also considered in creating and evaluating the list of diagnoses.<ref>{{Cite journal |last1=Fusco |first1=Francesco Maria |last2=Pisapia |first2=Raffaella |last3=Nardiello |first3=Salvatore |last4=Cicala |first4=Stefano Domenico |last5=Gaeta |first5=Giovanni Battista |last6=Brancaccio |first6=Giuseppina |date=2019-07-22 |title=Fever of unknown origin (FUO): which are the factors influencing the final diagnosis? A 2005-2015 systematic review |journal=BMC Infectious Diseases |volume=19 |issue=1 |pages=653 |doi=10.1186/s12879-019-4285-8 |issn=1471-2334 |pmc=6647059 |pmid=31331269}}</ref>
 
The list is dynamic and changes as the physician obtains additional information that makes a condition more (“rule-in”) or less (“rule-out”) likely based on the disease profile.<ref>{{Cite journal |last1=Knuuti |first1=Juhani |last2=Ballo |first2=Haitham |last3=Juarez-Orozco |first3=Luis Eduardo |last4=Saraste |first4=Antti |last5=Kolh |first5=Philippe |last6=Rutjes |first6=Anne Wilhelmina Saskia |last7=Jüni |first7=Peter |last8=Windecker |first8=Stephan |last9=Bax |first9=Jeroen J. |last10=Wijns |first10=William |date=2018-09-14 |title=The performance of non-invasive tests to rule-in and rule-out significant coronary artery stenosis in patients with stable angina: a meta-analysis focused on post-test disease probability |url=https://pubmed.ncbi.nlm.nih.gov/29850808 |journal=European Heart Journal |volume=39 |issue=35 |pages=3322–3330 |doi=10.1093/eurheartj/ehy267 |issn=1522-9645 |pmid=29850808}}</ref> <ref>{{Cite journal |last1=Westwood |first1=Marie |last2=Ramaekers |first2=Bram |last3=Grimm |first3=Sabine |last4=Worthy |first4=Gill |last5=Fayter |first5=Debra |last6=Armstrong |first6=Nigel |last7=Buksnys |first7=Titas |last8=Ross |first8=Janine |last9=Joore |first9=Manuela |last10=Kleijnen |first10=Jos |date=May 2021 |title=High-sensitivity troponin assays for early rule-out of acute myocardial infarction in people with acute chest pain: a systematic review and economic evaluation |journal=Health Technology Assessment (Winchester, England) |volume=25 |issue=33 |pages=1–276 |doi=10.3310/hta25330 |issn=2046-4924 |pmc=8200931 |pmid=34061019}}</ref>  The list is used to determine what information will be acquired next, including which diagnostic test or imaging modality to order.  The selection of tests is also based on the physician’s knowledge of the [[Sensitivity and specificity|specificity and sensitivity]] of a particular test.<ref>{{Cite journal |last1=Hegedus |first1=E. J. |last2=Goode |first2=A. |last3=Campbell |first3=S. |last4=Morin |first4=A. |last5=Tamaddoni |first5=M. |last6=Moorman |first6=C. T. |last7=Cook |first7=C. |date=February 2008 |title=Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests |url=https://pubmed.ncbi.nlm.nih.gov/17720798 |journal=British Journal of Sports Medicine |volume=42 |issue=2 |pages=80–92; discussion 92 |doi=10.1136/bjsm.2007.038406 |issn=1473-0480 |pmid=17720798|s2cid=9717602 }}</ref><ref>{{Cite journal |last1=Wacker |first1=Christina |last2=Prkno |first2=Anna |last3=Brunkhorst |first3=Frank M. |last4=Schlattmann |first4=Peter |date=May 2013 |title=Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis |url=https://pubmed.ncbi.nlm.nih.gov/23375419 |journal=The Lancet. Infectious Diseases |volume=13 |issue=5 |pages=426–435 |doi=10.1016/S1473-3099(12)70323-7 |issn=1474-4457 |pmid=23375419}}</ref><ref>{{Cite journal |last1=Garcia-Casal |first1=Maria Nieves |last2=Pasricha |first2=Sant-Rayn |last3=Martinez |first3=Ricardo X. |last4=Lopez-Perez |first4=Lucero |last5=Peña-Rosas |first5=Juan Pablo |date=2021-05-24 |title=Serum or plasma ferritin concentration as an index of iron deficiency and overload |journal=The Cochrane Database of Systematic Reviews |volume=2021 |issue=5 |pages=CD011817 |doi=10.1002/14651858.CD011817.pub2 |issn=1469-493X |pmc=8142307 |pmid=34028001}}</ref>
 
An important part of this process is knowledge of the various ways that a disease can present in a patient.  This knowledge is gathered and shared to add to the database of disease profiles used by physicians. This is especially important in rare diseases.<ref>{{Cite journal |last=Al-Mogairen |first=Sultan M. |date=August 2011 |title=Lupus protein-losing enteropathy (LUPLE): a systematic review |url=https://pubmed.ncbi.nlm.nih.gov/21344315 |journal=Rheumatology International |volume=31 |issue=8 |pages=995–1001 |doi=10.1007/s00296-011-1827-9 |issn=1437-160X |pmid=21344315|s2cid=21008365 }}</ref>