Change the definition of clinical picture

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At the SSFW09 workshop, a new definition of clinical picture was proposed
and largely agreed to:

clinical picture: A representation of the clinically significant bodily
features of the patient that is inferred from the totality of clinical
findings about a given patient.

Original issue reported on code.google.com by hoga...@gmail.com on 4 Sep 2009 at 5:11

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Reflecting on this definition nearly a month hence from SSFW09, the words 
"clinically
significant" are too weak.  

The bodily features that go into the clinical picture vs. those that are 
excluded
"hang together" in a way that goes beyond just clinical significance.  It almost
suggests a common etiology, or a prototypical case of a particular disease.

Original comment by hoga...@gmail.com on 1 Oct 2009 at 1:34

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Perhaps we have been thinking about Clinical Picture in quite the opposite way 
i.e. from a patient point of view, 
when in fact we need to look at it from a disease context -  as a description 
of all the different manifestations of 
a Disease. 
The usage of the term e.g. clinical picture of Thyrotoxicosis, clinical picture 
of Tuberculosis in 
immunocompromised patients, etc suggests that the clinical picture is not 
'inferred' but rather is the 'result' of a 
disease/disorder.

Original comment by arab...@gmail.com on 1 Oct 2009 at 2:17

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See remarks in http://groups.google.com/group/information-
ontology/browse_thread/thread/90a0712c2c766ee7/92e65ea107232ce8?
lnk=gst&q=canonical#92e65ea107232ce8 regarding canonical pathologies

Original comment by alanruttenberg@gmail.com on 1 Oct 2009 at 9:24

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The SSFW09 definition is an improvement, and thus will be used in OGMS v0.3, 
but this
issue will be left open for further discussion.

Original comment by albertgo...@gmail.com on 20 Nov 2009 at 9:16

• Changed state: Started

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Barry Smith suggests the following change for the definition of clinical 
picture:

"representation of the clinically significant bodily
components and/or bodily processes of a human being that is inferred
from the totality of relevant clinical findings"

Original comment by albertgo...@gmail.com on 29 Jun 2010 at 4:54

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I agree this time and withdraw my previous objection.

Original comment by hoga...@gmail.com on 2 Jul 2010 at 9:54

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Propose a small change to the definition to differentiate Clinical picture from 
Clinical presentation

Clinical picture: Totality of all the (relevant) clinical manifestations of a 
disease or disorder. This includes the different stages a disease can progress 
in, different presentations such as acute and chronic, disease course(s), etc.

Clinical presentation: The set of symptoms and signs a patient exhibits when 
seen by a physician. This may be further refined into 'initial clinical 
presentation' (when first seen) and 'later clinical presentation' (disease 
progression). Typically, the 'clinical presentation of a disease in an 
individual' will be a subset of the 'clinical picture of a disease'.

Original comment by sivaram....@gmail.com on 13 Jul 2010 at 8:40