Doctors, especially GP's, have to live with high degrees of uncertainty over diagnoses. The purpose of history-taking, clinical examination, tests and investigations is to narrow the uncertainty enough to be able to put a diagnostic label on the condition to enable subsequent action. Empirical trials of medication and expectant observation ('masterly inactivity' by letting time pass) can also be applied.
How far the process is taken depends on the doctor's and the patient's tolerance of uncertainty, the severity and treatability of the suspected disease and the benefits and risks of possible treatments.
It is important to ask whether a planned test or referral is likely to alter the management of the condition and whether the patient is likely to be better off for having had the test or referral.
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