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#ClinicSpeak: delayed MS diagnosis

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Does having a delayed diagnosis of MS matter? #ClinicSpeak #MSBlog

In this week's BMJ there is a short case study of a person with a delayed diagnosis of MS. Does it matter? 

Kieran Walsh. Are you “satisficed” with clinical decision support? BMJ 13 May 2017: page 282.


..... A 60 year old woman goes to her doctor with dizziness and poor balance. Her doctor is not sure what is wrong but thinks about postural hypotension, Meniere’s disease, and benign positional paroxysmal vertigo. He cannot find anything on examination, and all tests come back negative. 

...... He tells the patient that he cannot find a physical cause for her poor balance and suggests physiotherapy. A year later, the symptoms have got worse, and the patient is eventually diagnosed with multiple sclerosis.....

..... She wonders why she couldn’t have been diagnosed earlier. So why couldn’t she have been diagnosed earlier? One possibility is that her doctor was “satisficed” with the differential diagnosis too quickly..... 

...... Satisficing is a portmanteau of satisfy and suffice. It means that when you make a decision, you think through alternatives until you decide that you have done an acceptable job. But the problem is that the threshold for acceptability is subjective, and many people are “satisficed” too soon.....

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