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Symptoms and signs
Strictly speaking, a symptom is defined as any manifestation of disease. We use the term here more generally to refer to any type of subjective complaint, apparent only to the affected person. Examples would be pain of any type, including headache, itching, nausea, dizziness, etc. In this sense, in terms of many of our modules, the word may not necessarily indicate the presence of a disease or condition.
A sign, on the other hand, is detectable by another person and sometimes by the patient himself. Examples of physical signs include swollen joints, heart murmurs, and high blood pressure. Some phenomena can be both a sign and a symptom, such as fever, fainting, jaundice, rash, cough, hearing loss, and the like.
The National Ambulatory Medical Care Survey, (NAMCS) by the Department of Health and Human Services, last published summary was the survey of 2003, published in 2005. See also the National Center for Health Statistics site. NAMCS is an invaluable and extensive compilation of various characteristics of ambulatory care visits made to physicians within the United States. EasyDiagnosis bases prevalence of symptoms, signs, and diseases or conditions largely on data obtained from this source as well as on hospital discharge data from the NCHS; although we employ many other sources as well.
In 2003, an estimated 906 million visits were made to physician offices in the United States, an overall rate of 317.3 visits per 100 persons. 60% of the visits were to "primary care specialists" (general and family physicians, internal medicine, pediatrics, and OB-GYN). Although NAMCS states that about half of all visits "were made for reasons classified as symptoms" analysis indicates this figure may be misleading. For example, in 1999 10% of all visits were for general medical, well-baby, or routine prenatal examination, 11.5% (2003) were made for injuries or poison-related, and 16% of all visits were for preventive or nonillness care, including pre-and post-op and post-injury visits.
If one eliminates the sum of these percentages, 37.5%, effectively normalizing the figure for corrected "symptom visits" the actual figure of 50% turns out to be a much higher percentage of all visits. That is, if one eliminates routine, prenatal, injuries, poisonings, and nonillness care, at least 84% or more of all patients visiting U.S. physicians did so because of a symptom or symptoms, (or presumably signs). In a recent New York Times medical article, the author estimates that unexplained symptoms are the reason for over 100 million doctor visits a year.
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