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Cited by 8Patient-Provider Communication in HealthcareClinical Reasoning and Diagnostic SkillsEmpathy and Medical Education

Understanding Diagnostic Conversations in Clinical Practice: A Systematic Review

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Huynh, Ky, Brito, Juan P., Bylund, Carma L., Prokop, Larry J., Ospina, Naykky Singh·2023·Patient Education and Counseling
DOI 10.1016/j.pec.2023.107949PMC PMC11002943
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Abstract

Objective Summarize frameworks to understand diagnostic conversations and assessments of diagnostic conversations in practice. Methods We systematically searched MEDLINE, Scopus, Cochrane, and other databases from inception to July 2022 for reports of diagnostic conversations. Two authors independently reviewed studies for eligibility, assessed methodological quality with the mixed methods appraisal tool and extracted information related to study characteristics, frameworks and components evaluated in assessments of diagnostic conversations and results. Results Eight studies were included. One study reported an empiric framework of diagnostic conversations that included the following components: identifying the problem that requires diagnosis, obtaining information, and delivering the diagnosis and treatment plan. Thematic analyses highlighted communication between patients and clinicians as central in diagnostic conversations as it allows a) patient's presentation of their symptoms which guide subsequent diagnostic steps, b) negotiation of the significance of the patient's symptoms through conversation and c) introducing and resolving diagnostic uncertainty. Conclusion Despite the importance of diagnostic conversation only one empiric framework described its components. Additionally, limited available evidence suggests patients can have an important role in the diagnostic process that expands beyond patients as an information source. Practice implications Patients should be…

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  • The quality and completeness of information exchange are shaped by both communication and the relationship between patient and clinician, which directly impacts diagnostic outcomes.

    “The quality and completeness of information exchange are shaped by both communication and the relationship between patient and clinician, which directly impacts diagnostic outcomes [26].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [26]

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Authors
Huynh, K., Brito, J. P., Bylund, C. L., Prokop, L. J., & Ospina, N. S.
Affiliations
  • University of Florida (US)
  • Mayo Clinic (US)
  • University of Florida Health (US)
Corresponding author
Ospina, Naykky Singh
ORCID
Venue
Patient Education and Counseling
Publisher
Elsevier BV
Published
2023-11
Volume
116
Pages
107949
ISSN
0738-3991 (ISSN-L)
DOI
10.1016/j.pec.2023.107949
PMC
PMC11002943
OpenAlex
W4386154533
Cited by
8
References
42
Citations by year
2026: 4 · 2025: 3 · 2024: 1
FWCI
0.40
Type
journal article
Language
en
Open access
Licence
Locations
  • Patient Education and Counseling (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Cancer Institute (K08CA248972)
  • National Academy of Medicine
Topics
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
Keywords
physician-patient communication, diagnostic uncertainty, diagnostic planning, patient-clinician communication, shared decision-making
MeSH terms
Communication, Humans, Physician-Patient Relations

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