{"id":8833,"date":"2025-12-12T15:02:30","date_gmt":"2025-12-12T14:02:30","guid":{"rendered":"https:\/\/family-medicine.org\/anamnese\/"},"modified":"2025-12-12T15:49:38","modified_gmt":"2025-12-12T14:49:38","slug":"anamnese","status":"publish","type":"post","link":"https:\/\/family-medicine.org\/de\/anamnese\/","title":{"rendered":"80% der Diagnose ist Anamnese. Mythos oder Evidenzbasiert?"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"8833\" class=\"elementor elementor-8833 elementor-8825\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-cfbb03e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"cfbb03e\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d7e3c38\" data-id=\"d7e3c38\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-75ea62d elementor-widget elementor-widget-text-editor\" data-id=\"75ea62d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Die meisten von uns kennen diese Aussage und haben sie als \u201eWahrheit\u201c akzeptiert. Aber woher stammt sie eigentlich? Von einem Cochrane Review, oder Hippocrates? Hier die Aufl\u00f6sung.<\/p><h3><strong>Der Ursprung dieser Erz\u00e4hlung<\/strong><\/h3><p>Diese weltber\u00fchmte Aussage stammt von einer kleinen, 50-Jahre alten Studie im <a href=\"https:\/\/www.jstor.org\/stable\/20473216\">BMJ<\/a>:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cc85bd0 elementor-widget elementor-widget-image\" data-id=\"cc85bd0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"378\" src=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/1-1024x378.png\" class=\"attachment-large size-large wp-image-8826\" alt=\"\" srcset=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/1-1024x378.png 1024w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/1-300x111.png 300w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/1-768x283.png 768w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/1-1200x443.png 1200w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/1.png 1249w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" data-attachment-id=\"8826\" data-permalink=\"https:\/\/family-medicine.org\/1-2\/\" data-orig-file=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/1.png\" data-orig-size=\"1249,461\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"1\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/1-1024x378.png\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1128555 elementor-widget elementor-widget-text-editor\" data-id=\"1128555\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Bei 80 Patienten wurde die initiale Diagnose von ihrem Hausarzt mit der Diagnose nach zwei Monaten Klinikaufenthalt verglichen. Bei <strong>83%<\/strong> wurde die initiale Diagnose best\u00e4tigt. Zu jeweils 9% \u00e4nderten die k\u00f6rperliche oder die Labor-Untersuchung die sp\u00e4tere Diagnose.<\/p><h3><strong>Die aktuelle Evidenzlage<\/strong><\/h3><ul><li>Interessanterweise haben vergleichbare Studien von <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC1003190\/\">1992<\/a>, <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11273467\/\">2000<\/a> und <a href=\"https:\/\/www.scielo.br\/j\/spmj\/a\/8v6dxDL8HvTqGqrcqQk9f4M\">2003<\/a>, dieses Ergebnis <strong>best\u00e4tigt<\/strong>. Die Anamnese f\u00fchrte bei <strong>76%<\/strong>, <strong>79% <\/strong>und<strong> 78%<\/strong> zur schlussendlichen Diagnose.<\/li><li>Selbst <strong>ChatGPT<\/strong> erzielte <a href=\"https:\/\/mededu.jmir.org\/2024\/1\/e52674\">2024<\/a> bei 30 BMJ-Fallvignetten eine diagnostische \u00dcbereinstimmung von <strong>77%<\/strong>.<\/li><li>Die <strong>Ausnahme<\/strong> war eine gro\u00dfe <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/0002870380900769\">kardiologische<\/a> Studie von 1980 mit nur <strong>56%<\/strong>. Eine m\u00f6gliche Erkl\u00e4rung liegt darin, dass die Bildgebung in einem spezialisiertes Krankenhaussetting relevanter ist.<\/li><\/ul><p>Hier die Ergebnisse dieser Studien:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-160fba7 elementor-widget elementor-widget-image\" data-id=\"160fba7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1024\" height=\"826\" src=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/Bildschirmfoto-2025-12-12-um-15.30.53-1024x826.png\" class=\"attachment-large size-large wp-image-8841\" alt=\"\" srcset=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/Bildschirmfoto-2025-12-12-um-15.30.53-1024x826.png 1024w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/Bildschirmfoto-2025-12-12-um-15.30.53-300x242.png 300w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/Bildschirmfoto-2025-12-12-um-15.30.53-768x619.png 768w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/Bildschirmfoto-2025-12-12-um-15.30.53.png 1147w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" data-attachment-id=\"8841\" data-permalink=\"https:\/\/family-medicine.org\/bildschirmfoto-2025-12-12-um-15-30-53-2\/\" data-orig-file=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/Bildschirmfoto-2025-12-12-um-15.30.53.png\" data-orig-size=\"1147,925\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Bildschirmfoto-2025-12-12-um-15.30.53\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/12\/Bildschirmfoto-2025-12-12-um-15.30.53-1024x826.png\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-184b6a6 elementor-widget elementor-widget-text-editor\" data-id=\"184b6a6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><strong>Meine Gedanken<\/strong><\/h3><p>Die \u201eber\u00fchmten 80%\u201c wurden von anderen Studien best\u00e4tigt. Zu bedenken ist jedoch:<\/p><ul><li>Ein <strong>Systematic Review<\/strong> scheint zu dieser Fragestellung nicht vorzuliegen. Vielleicht habe ich eine relevante Studie \u00fcbersehen.<\/li><li>Die meisten Studien sind schon <strong>\u00e4lter<\/strong>. Mittlerweile gab es technologische Fortschritte und anamnestische Fertigkeiten wurden <a href=\"https:\/\/www.ijme.net\/archive\/9\/the-decline-of-clinical-skills\/\">vernachl\u00e4ssigt<\/a>.<\/li><li>Die Studien wurden haupts\u00e4chlich in <strong>Krankenh\u00e4usern<\/strong> durchgef\u00fchrt. In der Allgemeinmedizin k\u00f6nnte die Anamnese <strong>noch wichtiger <\/strong>sein.<\/li><li>Die \u201e80%\u201c sind ein <strong>Durchschnittswert<\/strong>. Bei unterschiedlichen Symptomen (z.B. Dysurie vs. Bewusstlosigkeit) oder Diagnosen (z.B. Depression vs. Hypertonie) variiert die tats\u00e4chliche Aussagekraft der Anamnese deutlich.<\/li><\/ul><h3><strong>Schlussfolgerungen f\u00fcr Haus\u00e4rzte<\/strong><\/h3><p>Die Anamnese bleibt das <strong>zentrale <\/strong><a href=\"https:\/\/bjgp.org\/content\/58\/549\/273\"><strong>diagnostische Instrument<\/strong><\/a> der Allgemeinmedizin. Sie erm\u00f6glicht die gezielte Nutzung aller anderen technischen Verfahren und kann \u00dcberdiagnostik vermeiden. In der (Krankenhaus-lastigen) medizinischen Ausbildung und in der Wissenschaft wird sie leider dennoch vernachl\u00e4ssigt.<\/p><p><a href=\"https:\/\/www.bmj.com\/content\/321\/7268\/1087.2\/rr\/760724\">Sir William Osler<\/a> (\u201eVater der modernen Medizin\u201c) hatte recht, als er meinte:<\/p><blockquote><p><em>\u201eH\u00f6re deinem Patienten zu; er erz\u00e4hlt dir die Diagnose.\u201c<\/em><\/p><\/blockquote>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Die meisten \u00c4rzte akzeptieren die Aussage, dass 80% der Diagnose allein durch die Anamnese gestellt wird, als etablierte Wahrheit. Diese Statistik geht aber auf eine 50 Jahre alte BMJ-Studie zur\u00fcck. \u00dcberraschenderweise best\u00e4tigen sp\u00e4tere Untersuchungen das jedoch ziemlich genau. Erfahre, warum Zuh\u00f6ren die effektivste \u201eTechnologie\u201c der modernen Medizin bleibt.<\/p>\n","protected":false},"author":93452803,"featured_media":8907,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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