Chapter 003 Decision-Making in Clinical Medicine (Part 10) pps

... different physicians. In short, the assumption is that there is an element of randomness (in the sense of disorder rather than in the formal statistical sense) to clinical management. In such cases, ... main patients treated medically during the 1970s (the last time these patients were routinely treated with medicine alone) would be extremely misleading since the quality of &qu...

Ngày tải lên: 06/07/2014, 08:20

... adult heart has been viewed as a terminally differentiated organ without the capacity for Chapter 067. Applications of Stem Cell Biology in Clinical Medicine (Part 2) Strategies for Stem Cell ... considered (Fig. 67-1): (1) injection of stem cells directly into the damaged organ or into the circulation, allowing them to "home" into the damaged tissue; (2) in vi...

Ngày tải lên: 07/07/2014, 01:20

... Chapter 003. Decision-Making in Clinical Medicine (Part 1) Harrison's Internal Medicine > Chapter 3. Decision-Making in Clinical Medicine Decision-Making in Clinical Medicine: ... Uncertainty is compounded by the information overload that characterizes modern medicine. Today's experienced clinician needs close to 2 million pieces of inform...

Ngày tải lên: 06/07/2014, 08:20

... Chapter 003. Decision-Making in Clinical Medicine (Part 2) The following three examples introduce the subject of clinical reasoning:  A 46-year-old man presents to his internist ... therefore more influential on clinical judgments. The third commonly used cognitive shortcut, the anchoring heuristic, involves estimating a probability by starting from a familiar point...

Ngày tải lên: 06/07/2014, 08:20

... disease is the underlying cause. The absence of a resting Chapter 003. Decision-Making in Clinical Medicine (Part 3) Diagnostic Hypothesis Generation Cognitive scientists studying the thought ... make teaching diagnostic reasoning difficult is that expert clinicians do not follow a fixed pattern in patient examinations. From the outset, they are generating, refining, an...

Ngày tải lên: 06/07/2014, 08:20

... influence this role include the physician's knowledge, training, and experience. It is obvious that physicians cannot practice evidence-based medicine (EBM; described later in the chapter) if ... therapy in their heart failure patients because they are more familiar with what the targets are (as defined by large clinical trials), have more familiarity with the specific drugs...

Ngày tải lên: 06/07/2014, 08:20

... patients Chapter 003. Decision-Making in Clinical Medicine (Part 5) Economic Incentives Economic incentives are closely related to the other two categories of practice-modifying factors. Financial ... understanding of the patient's problem qualifies as a diagnostic test. Thus, even the history and physical examination can be considered a form of diagnostic test. In...

Ngày tải lên: 06/07/2014, 08:20

... predictive value is best avoided in favor of the more informative posttest probability. Chapter 003. Decision-Making in Clinical Medicine (Part 6) Calculating sensitivity and specificity ... response in a treadmill exercise test) to the exclusion of other potentially relevant data. In addition, ROC area comparisons do not simulate the way test information is actuall...

Ngày tải lên: 06/07/2014, 08:20

... whereas test specificity will be higher in outpatients. times more likely in a patient with the disease than in a patient without it. Most tests in medicine have likelihood ratios for a positive ... finding of a reversible exercise-induced perfusion defect has both a sensitivity and specificity of 90%, yielding a likelihood ratio for a positive test of 9.0 [0.90/(1 – 0.90)]. I...

Ngày tải lên: 06/07/2014, 08:20

... considered, their relevant Chapter 003. Decision-Making in Clinical Medicine (Part 8) Statistical Prediction Models Bayes' theorem, as presented above, deals with a clinical prediction problem ... of HIV infection and the prevalence and incidence of HIV infection in the population targeted. This model, which required over 75 separate data points, provides novel...

Ngày tải lên: 06/07/2014, 08:20