Clinical Diagnosis Tools

The quality and reliability of health information on the Web vary widely. When evaluating Web-based health information, consider the site's source and funding, how often it is updated, the author's credentials and affiliations, and whether that information is clearly stated. For more information about how to evaluate Web resources, see Website Evaluation and Citing.

Please note: the materials presented here are intended to lead clinicians to a selective list of reliable resources of diagnostic information. This list is meant to be representative, not exhaustive.

Please send any comments concerning this page to Karen Odato.


Overviews of Evidence-Based Diagnosis

Web Essay on Evidence-Based Diagnosis from Bandolier
http://www.jr2.ox.ac.uk/bandolier/booth/diagnos/Diagessy.html

How to Read an Article on a New Diagnostic Test
http://www.pitt.edu/~super1/lecture/lec0342/001.htm

How to Use an Article About a Diagnostic Test
http://www.cche.net/usersguides/diagnosis.asp
Roman Jaeschke, Gordon H. Guyatt, David L. Sackett, and the Evidence Based Medicine Working Group; Centres for Health Evidence Based on the Users' Guides to Evidence-based Medicine and reproduced with permission from JAMA. (1994;271(5):389-391) and (1994;271(9):703-707). Copyright 1995, American Medical Association.

How to Use an Article About Disease Probability for Differential Diagnosis
http://www.cche.net/usersguides/probability.asp
W. Scott Richardson, Mark C. Wilson, Gordon H. Guyatt, Deborah J. Cook, James Nishikawa, and the Evidence Based Medicine Working Group Based on the Users Guides to Evidence-based Medicine and reproduced with permission from JAMA. (1999 Apr 7; 281(13):1214-9). Copyright 1999, American Medical Association.


Major Tools

DXplain
http://www.merckmedicus.com
DXplain is a decision support system which uses a set of clinical findings (signs, symptoms, laboratory data) to produce a ranked list of diagnoses which might explain (or be associated with) the clinical manifestations. DXplain provides justification for why each of these diseases might be considered, suggests what further clinical information would be useful to collect for each disease, and lists what clinical manifestations, if any, would be unusual or atypical for each of the specific diseases. Developed by the Massachusetts General Hospital.
Note: Registration but no payment is required;users must have a current medical license to access DXplain from this site.

The Merck Manual of Diagnosis and Therapy
http://www.merck.com/pubs/mmanual/sections.htm
An online searchable and browsable version of the popular print manual.


History and Physical Exam Tools

Bedside Diagnosis: An Annotated Bibliography of Literature on Physical Examination and Interviewing
http://www.acponline.org/public/bedside/index.html
This is an online version of the third edition of a book written by Henry Schneiderman, MD, FACP, and Aldo J. Peixoto, MD, and published by the American College of Physicians-American Society of Internal Medicine in 1997. Bedside Diagnosis provides an extensive and comprehensive review of the available literature pertaining to both physical diagnosis and interviewing. The papers, books, and tapes reviewed are described succinctly with their strengths and weaknesses clearly outlined.

The Screening Physical Exam
http://www.meddean.luc.edu/lumen/meded/medicine/pulmonar/pd/contents.htm
From the Loyola University Chicago Stritch School of Medicine. "The Screening Physical Exam steps have been developed to meet the needs of the Stritch School of Medicines' sophomore students...For each step the objective, method of exam, normal, abnormal and required knowledge are provided in separate modules. Consultants have reviewed steps pertinent to their field for accuracy and provided material for abnormalities."

A Practical Guide to Clinical Medicine
http://meded.ucsd.edu/clinicalmed/
A comprehensive physical examination and clinical education site for medical students and other health care professionals from University of California, San Diego.

The R.A.L.E.® Repository
http://www.rale.ca/Recordings.htm
The R.A.L.E.® Repository (Respiration Acoustics Laboratory Environment) presents digital recordings of respiratory sounds in health and disease.

The Auscultation Assistant
http://www.wilkes.med.ucla.edu/intro.html
The Auscultation Assistant provides heart sounds, heart murmurs, and breath sounds in order to help medical students and others improve their physical diagnosis skills.

The Neuro Exam
http://www.neuroexam.com/
An interactive online guide to the neurological exam with video demonstrations.


Diagnostic Calculator Tools

EBM Statistics Calculator: Diagnostic Tests
http://www.cebm.utoronto.ca/practise/ca/statscal/
From the Centre for Evidence-Based Medicine in Toronto. Calculates the Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, and Likelihood Ratios.

Diagnostic Test Calculator
http://araw.mede.uic.edu/cgi-bin/testcalc.pl
Developed by Dr. Alan Schwartz Assistant Professor of Clinical Decision Making in the Department of Medical Education at the University of Illinois at Chicago.

The Medical Algorithms Project
http://www.medal.org/
A Medical Algorithm is any computation, formula, survey, or look-up table, useful in healthcare. Over 3000 algorithms spanning major medical domains, organized into 44 chapters.

Clinical Decision Making Calculators
http://www.fammed.ouhsc.edu/robhamm/cdmcalc.htm
This site includes many spreadsheet calculators; each spreadsheet performs a common calculation useful for clinical decisions or for analyzing data pertinent to clinical decisions. Developed by Robert M. Hamm, PhD, Associate Professor and Director, Clinical Decision Making Program, Dept. of Family and Preventive Medicine, U of Oklahoma Health Sciences Center.

Likelihood ratios from the Bandolier archives
http://www.jr2.ox.ac.uk/bandolier/booth/diagnos/Liketab.html
Reports on the development of likelihood ratios calculated for a variety of conditions (e.g., OAD, anemia, TB.)


Screening Tools

Screening Reports from Bandolier
http://www.jr2.ox.ac.uk/bandolier/booth/booths/diag.html#screen
Reports on the value of screening for many different diseases/conditions.


Laboratory Testing Tools

Handbook for Interpretation of Laboratory Tests
http://www.dml.co.nz/clin_handbook.asp
From Diagnostic MedLab, a large laboratory in New Zealand.

Clinical Laboratory Science Internet Resources
http://members.tripod.com/~LouCaru/index-5.html
An extensive list of resources developed by Louis B. Caruana, Ph.D., MT(ASCP), Professor Emeritus, Clinical Laboratory Science Program, College of Health Professions, Southwest Texas State University, San Marcos, TX.


Imaging Tools

CHORUS (Collaborative Hypertext of Radiology)
http://chorus.rad.mcw.edu/
From the Medical College of Wisconsin. CHORUS is a "quick reference" hypertext for physicians and medical students. More than 1,100 documents describe: diseases, radiological findings, differential-diagnosis lists ("gamuts"), and pertinent anatomy, pathology, and physiology.

Whole Brain Atlas
http://www.med.harvard.edu/AANLIB/home.html
From the Harvard Medical School. An online atlas of MR images of the brain. Includes sections on the normal brain, cerebrovascular disease, degenerative disease, neoplastic disease, and inflammatory/infectious disease. Includes "tours" and MGEG movies.


Diagnosis Aggregate sites
Web sites with links to many Diagnosis sites.

Karolinska Institutet site
http://www.mic.ki.se/Diseases/e1.html
A comprehensive list from the National Resource Library for medicine, dentistry and nursing research in Sweden. Includes diagnosis sites in specific disciplines. In English.

Bandolier Library - Diagnostics
http://www.jr2.ox.ac.uk/bandolier/booth/booths/diag.html
Includes diagnosis sites in specific disciplines from the UK. Bandolier is a print and Internet journal about health care, using evidence-based medicine techniques to provide advice about particular treatments or diseases.


Diagnostic Tools for the PDA

Healthy Palm Pilot - Diagnosis
http://www.healthypalmpilot.com/Diagnosis/
Resources reviewed, rated, and available for download, including many free applications. [Click on "Signs and Symptoms" and/or "Diagnostic Criteria"]