Monday, March 23, 2015

Should standardized language be used to write a nutrition diagnosis?

For most diagnoses all that is needed is an ounce of knowledge, an ounce of intelligence, and a pound of thoroughness. 
Arabic Proverb. In Lancet (1951). In John Murtagh, General Practice (1998), 125. 

One question that was raised during the MEDNA pilot survey last year was "Should standardized language be used to write a nutrition diagnosis?"

You really can't make a nutrition diagnosis UNLESS you have a standardized language.  In order to make a diagnosis of any kind, you must first have a list of diagnosis with descriptions that can be used to select/assign a nutrition diagnosis.  

To explain this thinking, here is a bit of background on the definition and description of "diagnosis".    

In  the Journal of the American Medical Association, in 1967 LS King, MD, discussed three critical components that needed to be present for the diagnosis process:  
     1-A preexisting series of categories or classes to provide the framework for the diagnosis
     2-A particular entity/situation that is being evaluated (patient's situation)
     3-The deliberate judgement that the entity being evaluated belongs to THIS particular category (versus other categories)

In this article King referenced an older reference, The Principles of Sciences:  A Treatise in Logic and Scientific Method  by Jevons, WS that was originally published in the 1830's and again in 1913.  It described diagnosis as follows:   

 " Diagnosis consists in comparing the qualities of a certain object with the definition of a series of classes;  the absence in the object of any one quality stated in the definition excludes it from the class thus defined;  whereas, if we fine every point of a definition exactly fulfilled in the specimen, we may at once assign to the class in question."  

Webster dictionary states that the first known use of the word diagnosis was in 1655 and it's language origin is from the Greek words,  diagignōskein meaning to distinguish and gignōskein meaning to know (Miriam Webster Dictionary)

So Bottom line:  You need to have a list of categories of nutrition diagnoses and corresponding descriptions that will allow the dietitian to accurately determine whether the patient's signs and symptoms match a preexisting definition of a particular nutrition diagnosis.


King, LS.  What is a Diagnosis?  Journal of American Medical Association.  1967;202(8):154-157.

Jevons, W S. The Principles of Sciences:  A Treatise in Logic and Scientific Method. Second ed.  London, Macmillan and Company, Ltd., 1913.

Current definitions of "Diagnosis" in dictionaries follow:

  • The act or process of identifying or determining the nature and cause of a disease or injury through evaluation of patient history, examination, and review of laboratory data.(The Free Dictionary)
  • The process of determining by examination the nature and circumstances of a diseased condition. (
  • The identification of the nature of an illness or other problem by examination of the symptoms(Oxford Dictionary)

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