Patients need to describe symptoms clearly to get accurate diagnosis

7th October 2015

Encouraging people to communicate their symptoms more clearly could help doctors give a more accurate diagnosis.

Retired doctor John Ely, speaking at an international conference of the Society to Improve Diagnosis in Medicine, said there were eight characteristics of a symptom that “good patients” could talk about, but they did not know about them.

He told the meeting in Washington DC they were:

  • Where is your pain or numbness? Not always suitable for more generalised symptoms like fatigue or shortness of breath.
  • How long have you had the symptom? If it's something intermittent -- like a spell of chest pain -- how often does it happen and how long does it last? Is it gradually getting worse? Getting better? Staying the same?
  • What were you doing when you first noticed the symptom? Were you just sitting there? Arguing with someone? This is particularly important if the patient is having dizziness, Ely noted.
  • Are any other symptoms associated with this one - for example, light-headedness or shortness of breath?
  • What is the "quality" of the symptom -- what does it feel like? "Patients sometimes say to me, 'What do you mean? It's just a pain, doc.' Well, is it like an elephant stepping on your chest, a fire in your chest, someone stabbing you with an ice pick, or what? I usually say]'Just tell me what it feels like,'" said Dr Ely.
  • What is the "quantity" of the symptom -- for example, how bad is it on a scale of one to 10?
  • What aggravates the symptom?
  • What alleviates the symptom?

He continued: “I also want to know a patient's chief complaint and then a paragraph -- not six paragraphs and not a novel -- and in that paragraph patients need to tell the doctor these eight things," he said.