Download PDF by Harold C. Sox: Medical Decision Making

Diagnosis

By Harold C. Sox

This ebook basically demonstrates how to most sensible make scientific judgements whereas incorporating medical perform guidelines and selection aid structures for digital scientific list structures.

New to this version is how clinical choice making principles are being integrated into scientific selection aid platforms in digital clinical files and likewise how they're getting used to form perform directions and policies.

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Based on their prevalence in North American patients, other diseases are far more likely than malaria to be the cause of fever, shaking chills, and sweats. Example 2: A 35-year-old woman with mild hypertension is obese and has prominent striae and moderately excessive facial hair. She does not take corticosteroids. The medical student clerk has just completed an endocrinology elective. He immediately suspects Cushing’s disease and tells his preceptor that there is a 30% chance that the patient has this disease.

This principle also follows from the definition of the likelihood ratio, which is the single number that best characterizes the value of the information contained in a pattern of clinical findings (see Chapters 4 and 5). • Strong evidence against one hypothesis increases the probability that another hypothesis is correct. This principle follows from the requirement that the sum of the probabilities of a set of mutually exclusive findings must add up to 1. Therefore, if the patient does not have a finding that is usually present in diagnosis A, diagnosis A becomes less likely and diagnosis B more likely.

27 28 Medical decision making We would not require clinical judgment to diagnose the disease; it would be sufficient to know if this finding were present. This clinical finding is fictional, an illusion. No clinical finding has this perfect, one-to-one correspondence with a disease. Therefore, clinicians are seldom, if ever, certain what a finding implies about the patient’s true state. They must recognize the following bleak truth: The true state of the patient lies locked within the body, inaccessible to direct observation.

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