Even the term diagnosis is used in different contexts.2 These contexts can shift the meaning of diagnosis depending on the on the observer’s vantage point. For instance, the National Academies define diagnosis simply as the explanation of a patient’s health problem.3 Some reference the term diagnosis as the absolute truth of a patient’s condition based on current scientific understanding of a disease and its manifestations on a cellular, molecular, or genetic basis, or a syndrome that may be defined by its patterns and constellations of signs and symptoms.
Some people use the term “diagnosis” to indicate a working hypothesis4 of a patient’s condition, subject to revision as understanding of the patient’s condition evolves. Thus, diagnosis can refer to the label applied to a patient’s condition or the process or activities to arrive at that label (e.g., to diagnose, diagnosing, diagnostic process).5 As these perspectives illustrate, the term can be either a noun or verb, a conclusion or process.6
Judgments about the correctness or adequacy of a diagnostic label or process can also change over time as science informs new understanding, as categorization of diagnosis is refined or further specified (e.g., not just a diagnosis of breast cancer, but a diagnosis of breast cancer with a specific estrogen receptor status), or as a patient’s condition evolves.
