There’s a lot of umbrella diagnoses that would benefit from more specific diagnostics first. What we call Alzheimer’s is probably actually caused by number of different causes depending on the person. This is true of a lot of things in medicine that get grouped together. That’s why testing a drug in mouse models with all the same characteristics sometimes works but fails to translate into humans who have more variety amongst each other.
The same is true of many diagnoses like pneumonia, cancer, alopecia, essential tremor: there’s multiple different groups that would benefit from different things, and if we had better ways to identify the groups, we’d give them what works for them instead of wasting their time with the wrong treatment. As an example, antibiotics won’t work for viral pneumonia and in addition to wasting the patient’s time, actually harm your microbiome. If you had a perfect way to know which is which, you’d always get the right treatment.
Precision medicine takes this even further.
You’re right, disease labels aren’t diagnostic.
Many disease labels just mean inflammation-of-a tissue / organ.
Worth noting that some viral inflections of the respiratory tract will have a bacterial secondary, where an either commensal bacteria has over proliferated or a pathogenic bacteria has started to get a hold, and treating the bacterial secondary can help the patient better fight the viral primary.
I recall a University of Washington (I think it was) where they were saying they had found Schizophrenia to be a bucket diagnosis, and had discovered that multiple sets of genes were working together in specific testable ways such that there were >4 sub types of Schizophrenia each with its own set of symptoms, and ability to respond to different medications.
The researcher did a follow-up study to confirm their thesis, but I've never seen anyone else follow up on those studies (family with Schizophrenia makes me acutely aware of developments in that field)
https://source.washu.edu/2014/09/schizophrenia-not-a-single-...
oh, would you look at that - a newer study https://biology.ucdavis.edu/news/discovery-hints-genetic-bas...
It's quite terrible how the medical "debugging" works or rather doesn't. You run a bunch (at best) of tests then pick the most probable diagnosis and that's about it for 99.9% of cases. And then in a review you measure that the world's best performing doctor hit 45% accuracy whereas an average one hits ~33%.