Proposed Terms

Diseases, Signs and Symptoms: Draft List of Proposed Definitions Richard Scheuermann, Werner Ceusters, Barry Smith

We use ‘abnormal’ to designate those bodily structures, processes or qualities which are associated to a significant degree with pain and other feelings of illness or with enhanced morbidity (the threshold degree of significance being determined by the community of clinicians).

Homeostasis =def. The events transpiring within the body fall within the range which allows bodily functioning to be sustained, and the bodily mechanisms for restoring values within the interior of this range are unimpaired.

                                         pathological process

                           acute	             chronic 	                progressive

marked by: reversion to normal resetting to abnormal failure to regain

                           homeostasis              homeostasis	        homeostasis

examples: cardiovascular elevated pulse rate heart murmur atherosclerosis neurological hangover dyslexia, epilepsy multiple sclerosis cancer reactive hyperplasia benign tumor malignant tumor anatomy acne missing limb leprosy infectious disease acute influenza chronic herpes virus infection Herpes-induced encephalitis leading to death

Pathological Process =def. A biological process in a human being that is of a type standardly classified by the community of clinicians as abnormal.

Acute Pathological Process =def. A pathological process beginning with a deviation from and terminating with a return to normal homeostasis.

Disorder =def. The physical result of a change in some part of the patient that is associated with a pathological process.

Acute Disorder =def. The physical result of a change in some part of the patient that is associated with an acute pathological process.

Chronic Pathological Process =def. A pathological process that results in an adaptation on the part of the patient to a level of abnormal homeostasis.

Chronic Disorder =def. The physical result of a change in some part of the patient that is associated, absent intervention, with a chronic pathological process.

Progressive Pathological Process =def. A pathological process that begins with a deviation from homeostasis and which continues to deviate in such a way as to preclude the re-establishment of homeostasis.

Progressive Disorder =def. The physical result of a change in the patient that is associated, absent intervention, with a progressive pathological process.

Physical Examination =def. A sequence of acts of observing and measuring the physical responses of a patient on the part of a physician occurring in the context of a clinical encounter.

Sign =def. A process or quality that is observed in a physical examination and is hypothesized by the clinician as a manifestion of a disorder.

Symptom =def. A quality of the patient that is observed and can be observed only by the patient and is of the type that can be hypothesized by the patient as a manifestion of a disorder.

Laboratory Test =def. A laboratory assay that is used to test a hypothesis about a given patient, and has input: a specimen derived from the patient, and output: a certain result which represents a quality of that patient.

Laboratory Test Result =def. A representation of a quality of a specimen that is the output of a laboratory test.

Finding =def. The result of either a laboratory test or a patient self-assessment (representation, by the clinician, of a symptom as reported by the patient, in the form of an assertion that this patient has this symptom) or a clinical examination (representation, by the clinician, of a sign, in the form of an assertion that this patient manifests this sign).

Clinical Phenotype =def. A constellation of those qualities associated with a disease at each stage of its development.

Clinical Picture A representation of a clinical phenotype inferred from the constellation of findings available to the clinician about a given a patient at any given stage.

Diagnosis =def. The result of an interpretive process which has input: a clinical picture of a given patient and conclusion: an assertion of the form ‘this patient has disease or disorder such and such’.