一貫性、一致性、整合性

ヒルの９つの因果性判断基準(Bradford Hill Criteria)にもあるConsistencyとCoherence、右記本では、それぞれ「一致性」、「整合性」と訳されており、問題点でもその異同が問題点として挙げられている。Clinical Problem-Solvingの過去のコメントには、coherence  = consistency with known pathophysiology の記述さえある。
一方、EU統計局 “ESS Quality Glossary 2010” Unit B1 “Quality; Classifications” 品質関係用語集（対訳）では、同じ語が「整合性」、「一貫性」と訳されており、きちんと峻別されている。
そこで、実際のこれらの語の運用を過去のClinical Problem-Solvingのコーパスで調べてみる。

一貫性、整合性(Coherence)

• Rather than try to deal with all these issues, we have chosen to try to devise a coherent explanation for the principal clinical features of the patient's case.
• When making a diagnosis a physician looks for a coherent pattern among a patient's symptoms and signs.
• Despite remittent fever (temperature, up to 40°C), he continued to feel well, to be coherent, and to have a good appetite.
• If they are too broad, even an experienced clinician can find it difficult to sift through large amounts of sometimes irrelevant information and formulate a coherent picture.
• The process of verification involves assessing each possibility with respect to coherency, adequacy, and parsimony.
• Nor did these hypotheses meet the test of diagnostic coherence.

一致性、整合性(Consistency)

• The physical examination was consistent with a hypovolemic state.
• Laboratory results were consistent with a systemic inflammatory response, possibly of rheumatologic origin.
• The electrocardiographic findings are consistent with an acute myocardial infarction.
• An electrocardiogram showed an irregular rhythm with high-amplitude, mildly prolonged QRS complexes that were consistent with atrial fibrillation with a rapid ventricular response, left ventricular hypertrophy, and interventricular conduction delay.
• She had a history of episodic retrosternal burning that was consistent with gastroesophageal reflux.
• Several test results appear to be consistent with hemolysis.
• Specimens from random colonic biopsies were consistent with nonspecific chronic inflammation with marked eosinophilia.
• A chest radiograph reportedly revealed scattered nodules and increased interstitial markings that were considered to be consistent with sarcoidosis.
• An electrocardiogram showed an acute injury pattern in the anterolateral wall of the heart that was consistent with ST-segment elevation myocardial infarction (STEMI) in the territory of the left anterior descending coronary artery.
• Primary neurologic processes that are consistent with this presentation include subdural hematoma, subarachnoid hemorrhage, stroke, and meningoencephalitis. 
•  Her skin had diffuse patchy areas of depigmentation on the arms, chest, neck, face, and scalp that were consistent with vitiligo.
• The constellation of hypotension, narrow pulse pressure, and cool extremities is consistent with what has been described as the “cold and wet” classification of acute heart failure, which is a type of cardiogenic shock.

一覧して、coherentは、一般論や患者の意識状態を述べるとき、consistentは、be consistent with の熟語で、suggest と同様、所見と疾患の関連を述べるときに使われていることがわかる。示さないが、後者は、suggest に比べると、より具体的な疾患に関連していることを示す傾向がある。従って、具体的なclinical reasoningにおいては、初盤でsuggestが、中盤以降でbe consistent withが多用される。

蛇足だが、consistent の最後の例文は、Nohriaの心不全の分類の記載。