This report, The changing nature of diagnosis, sets out the implications for practitioners and patients of the technological revolution in diagnosis. The report includes three priorities for action drawn from discussions with researchers, academics and health professionals.
State of the art diagnosis is often driven by technological innovation. Today, advances in medical imaging, molecular testing (including genomics), and computational analysis are increasingly capable of making significant contributions to the diagnostic process.
At the June 2025 roundtable convened by the PHG Foundation, PHG Foundation Fellow, Dr Zoë Fritz, led a multidisciplinary discussion of challenges in diagnostic practices driven by emerging technologies. The expert group identified priorities for future research, policy and practice, which we have synthesised into three areas of action:
Three areas for action:
1. Updating the taxonomy of diagnosis
The scope of possible diagnoses is evolving as our ability to detect disease, particularly in early forms, grows. But we may be asking one word – diagnosis – to capture too wide a range of activities and physiological states. Key distinctions exist between screening and diagnosis but their separation in practice is a matter of debate. These activities need to account for uncertainties which can be difficult to communicate. Detecting disease early or when a person’s physiology is close to the boundary between what is considered ‘normal’ or ‘pathological’ may benefit from further forms of description.
2. Strengthening evaluations of the impact of diagnostic tests on clinical outcomes
Systems exist for the evaluation of tests in different contexts (e.g. National Screening Committee for screening, ACCE for genetic testing and the NICE Diagnostic Advisory Committee). Current health data infrastructures do not allow for routine collection and continuous evaluation of diagnostic tests, locally or nationally. This limits scrutiny of the use of diagnostic tests particularly related to patient outcomes.
3. Communicating diagnosis in context
Diagnosis requires effective communication, both between healthcare professionals and with patients. The diagnostic process increasingly entails multi-disciplinary collaboration between clinicians. Each clinician needs to communicate their specialist knowledge – including uncertainties and limitations – to the construction of a diagnosis. Even specialities associated with a higher degree of ‘diagnostic objectivity’, such as radiology, involve interpretation. A test result is not a diagnosis and a clinician needs to put this result in the wider clinical context of the patient. Effective communication with patients requires knowledge exchange and should promote shared-decision making and autonomy.
Read The changing nature of diagnosis: implications for policy, practice and patients report now.
A short background briefing provided context and proposed points for discussion. Read: The changing nature of diagnosis – background briefing
We invite you to get in touch and share your views on this topic as we continue to track and analyse new developments.
