A sequential diagnostic model for medical questioning

I Am a Doctor, and Here is My Proof: Chinese Doctors' Identity Constructed on the Online Medical Consultation Websites

Despite a multitude of previous research focusing on doctors' identities which have been constructed through traditional face-to-face communication, their identities on online medical consultation websites are still underrepresented in research. This paper sketches out how Chinese doctors construct their online identities by analyzing 1,000 pieces of conversations between patients and doctors retrieved from 120ask.com. The analysis showed that Chinese doctors create professional identities online through the use of medical jargon, independent vocatives, and diagnostic questioning, while their authoritative identity is constructed by using collective vocatives to situate themselves as members of hospital communities and using a high modality to carve out their authoritative identities. Often Chinese doctors establish their individuality through self-reference, and highlight their ordinary side of their identities through the use of intimate vocatives and markers of politeness. To some extent, this study not only gives comprehensive answers to the research questions but also can serve as a facilitator of effective communication and good rapport management between doctors and patients in online consultation.

Medical diagnostic decision support systems--past, present, and future: a threaded bibliography and brief commentary

Articles about medical diagnostic decision support (MDDS) systems often begin with a disclaimer such as, "despite many years of research and millions of dollars of expenditures on medical diagnostic systems, none is in widespread use at the present time." While this statement remains true in the sense that no single diagnostic system is in widespread use, it is misleading with regard to the state of the art of these systems. Diagnostic systems, many simple and some complex, are now ubiquitous, and research on MDDS systems is growing. The nature of MDDS systems has diversified over time. The prospects for adoption of large-scale diagnostic systems are better now than ever before, due to enthusiasm for implementation of the electronic medical record in academic, commercial, and primary care settings. Diagnostic decision support systems have become an established component of medical technology. This paper provides a review and a threaded bibliography for some of the important work on MDDS systems over the years from 1954 to 1993.

Historical and methodological aspects of computer-assisted medical history-taking

The purpose is to draw, in a historical perspective, the main outlines of a theoretical and methodological approach of computer-assisted anamnesis (CAA). At the University of Liège (Belgium), studies on CAA were started in 1966, as an extension of previous works in the field of computer-assisted instruction (CAI). A short retrospect of the SIAM-DOCEO Project is given. Various factors contribute to reducing the place physicians effectively assign to history-taking, in spite of its essential role. Non-interactive self-administered questionnaires cope only very partially with that situation. For about 20 years, a number of CAA projects have been set up in many countries. Four basic questions dealing with the diffusion of CAA techniques are examined. (a) It is crucial not to put man-machine interaction and human dialogue on the same footing. A computer is quite unable to understand anything, but it can help health professionals in gathering medical history data. (b) As a rule, a CAA program should intervene in a limited and well defined pathological field, i.e. not too far from the diagnostic stage. (c) Acceptance by patients is very encouraging. (d) In contrast, reactions are mixed among physicians, essentially because of subjective factors. Accuracy and reliability, completeness and relevancy are, as a whole, undeniable qualities of CAA data, but the computer is--hopefully only for a short time--still often perceived more as a competitor than as a tool. The bibliography comprises 84 references.