Some factors affecting diagnostic accuracy

Diagnosis involves a complex and overlapping series of steps, each of which may be a source of error and of variability between clinicians. This varia tion may involve the ability to elicit relevant information from the client or animal, in the accuracy, objectivity and completeness of relevant memor y stores, and in psychological attributes including tolerance for uncertain ty and willingness to engage in constructive self-criticism. The diagnostic acumen of an individual clinician may not be constant, varying with extern al and personal factors, with different clients and cases, and with the use made of tests. In relation to clients, variations may occur in the ability to gain their confidence, to ask appropriate questions and to evaluate acc urately both verbal and nonverbal responses. Tests may introduce problems o f accuracy, validity, sensitivity, specificity, interpretation and general appropriateness for the case. Continuing effectiveness as a diagnostician t herefore requires constant attention to the maintenance of adequate and up- to-date skills and knowledge relating to the animals and their diseases and to tests, and of sensitive interpersonal skills.