Guide The Rational Clinical Examination: Evidence-Based Clinical Diagnosis (Jama & Archives Journals)

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Tympanic rapid, convenient reflects core temperature falsely low if cerumen present Defined as 99th percentile of maximum temperatures in healthy person Reeves, Confusion assessment method — Look for 1. Weight changes - DX nutritional state, neoplasm, volume status, chronic illness, eating disorders Prognosis Management. McGee, , Chapter Observe hands and feet Lips for blue discoloration not seen in sublingual mucous membranes. Pressure of seconds with finger over bony prominence produces pitting for pitting edema, recovers easily — non-pitting edema- does not pit easily.

Only if these fail, the usual HD method is recommended i. Not all of the 24 principles discussed were created equal. Both approaches are essential not only for reducing diagnostic error but also for continued improvement and learning. Adopting a systematic, methodical modus operandi is an additional theme with myriad benefits that we believe and translate into improved diagnostic skills I, II and XVII.

Other principles highlight the element of time as both a valuable diagnostic clue by itself, a diagnostic policy in non-urgent problems and an obligatory investment in complex ones I, XIII and XVIII.

Thus, the 24 principles have the potential to become useful in teaching and as a reminder to practicing clinicians in hospitals and primary care. The strength of the study is in the derivation of the principles from both long-term personal experience, research and the current literature.

Their usefulness for solving diagnostic problems has been repeatedly demonstrated in bedside teaching rounds and consultations, and has occasionally been published. Limitations include the entirely subjective selection process and lack of validation in controlled studies.

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Diagnostic errors, although little discussed in the renown Institute of Medicine report, 66 , continue to pose a significant danger to patient safety and the quality of care. Their potential to reduce diagnostic error remains to be examined in future research. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

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Close mobile search navigation Article Navigation. Volume Article Contents. Editor's Choice. Teaching clinical medicine: the key principals A. Oxford Academic. Google Scholar. Cite Citation. Permissions Icon Permissions. Abstract Background: Many studies analyse the diagnostic process, diagnostic errors and diagnostic excellence but few provide a broad, yet practical view of this complex and highly context-dependent challenge.

Teaching the Results of Studies

Table 1. Could it be iatrogenic? Is there a tenable alternative? What is it? Or what it is not!


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Google Preview. Utility of the clinical examination in the diagnosis of emergency department patients admitted to the department of medicine of an academic hospital.


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    A CD-ROM accompanies the book to enable students to test their learning through a series of questions, with answers provided. This is an ideal introductory text for medical students, health sciences students and a wide range of other healthcare professionals. McGarry; Iris L. The 5-Minute Consult Clinical Companion to Women's Health is a quick-reference guide to the diagnosis and management of symptoms and disorders that commonly occur in women.

    The contributors present practical, up-to-date, evidence-based information in a format designed for rapid consultation. Evidence-based medicine aims to apply the best available evidence gained from the scientific method to medical decision making. It is a practice that uses statistical analysis of scientific methods and outcomes to drive further experimentation and diagnosis.

    The profusion of evidence-based medicine in medical practice and clinical research has produced a need for life scientists and clinical researchers to assimilate biostatistics into their work to meet efficacy and practical standards. Practical Biostatistics provides researchers, medical professionals, and students with a friendly, practical guide to biostatistics.