Diagnostic Pathways in Clinical Medicine. An Epidemiological Approach to Clinical Problems

by B. J. Essex. 173 pages, illustrated. Churchill Livingstone, 19 West 44th Street, New York, N.Y. 10036. 1977. $9.95 (paper-bound)

Barnett L. ClineSchool of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112

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The author of this practical yet provocative book states that its aim is to “provide the student with the skills needed to make an accurate diagnosis in the outpatient clinic in less than 3 minutes per patient.” Developed for use in East Africa, the book is based on the premise that clinical skills learned in hospital wards are not readily transferred in a systematic manner to the outpatient clinic.

The proposed diagnostic method utilizes a series of 53 flow charts based on well defined signs and symptoms and applicable to a broad spectrum of presenting manifestations of disease. These charts help lead the health worker to an accurate diagnosis simply by noting the presence or absence of specific signs and symptoms. For those concerned with the oversimplification inherent in such an approach, the author clearly cautions the reader against misunderstanding or misusing the book.