By David Simel, Drummond Rennie
The last word consultant to the evidence-based scientific stumble upon "This booklet is a superb resource of supported facts that offers important and clinically correct info for the busy practitioner, scholar, resident, or educator who desires to hone abilities of actual prognosis. It presents a device to enhance sufferer care through the use of the historical past and actual exam goods that experience the main reliability and efficiency."--Annals of inner drugs "There is a smart deal to love approximately this publication. it's enthusiastic about universal medical dilemmas and is easily prepared, and such a lot chapters are a short read....The evidence-based exam innovations positioned forth by means of Rational medical exam the type that may be delivered to endure every day – to save lots of time, elevate self assurance in scientific judgements, and support reduce pointless trying out for stipulations that don't require absolute diagnostic simple task. after all, the full of this publication is bigger than its components and will function a important spouse to a conventional handbook of actual examination."--Baylor collage scientific heart (BUMC)Proceedings five celebrity DOODY'S assessment! "Physical prognosis has been taught to each scientific pupil yet this evidence-based technique now indicates us why, featuring certainly one of medicine's most elementary tenets in a brand new and hard gentle. The structure is notable, taking formerly released fabric and updating the pertinent facts because the preliminary book, putting forward or wondering or refining the conclusions drawn from the information. "This is a e-book for everybody who has studied medication and located themselves doubting what they've been taught through the years, now not that they have got been deluded, yet that clinical traditions were definitely believed simply because there has been no facts to think another way. The authors have exposed the truth." This striking, special ebook is a necessary addition to each scientific library."--Doody's assessment carrier within the culture of the recognized clients' publications to the scientific Literature, The JAMA sequence “The Rational medical exam” used to be created to deliver the foundations of evidence-based drugs to the diagnostic approach. that includes particular medical questions, various case examples, and specific summaries of obtainable proof, the RCE sequence was once an immediate hit. Now for the first actual time in ebook shape, thoroughly up to date with new literature analyses, here's a uniquely sensible, clinically suitable method of using facts within the content material of actual exam. Going some distance past the scope of conventional actual exam texts, this important source compiles and offers the evidence-based meanings of symptoms, indicators, and effects from actual exam maneuvers and different diagnostic reports. web page after web page, you will find a spotlight on real medical questions and displays, making it an incomparably sensible source that you will flip to time and again. Importantly, the high-yield content material of The Rational medical exam is considerably accelerated and up to date from the unique JAMA articles, a lot of it released right here for the 1st time. all of it provides as much as a definitive, ready-to-use medical examination sourcebook that no pupil or clinician might be with no. good points all of the specialist views at the program of evidence-based drugs principles-with all of the authority of the pioneering JAMA sequence, The Rational scientific exam jam-packed with up to date, new, and formerly unpublished info from the unique JAMA articles Standardized template for each factor lined, together with: Case Presentation; Why the problem Is Clinically very important; examine and Statistical equipment Used to discover the facts awarded; The Sensitivity and Specificity of every Key outcome; answer of the Case Presentation; and the medical final analysis thoroughly up-to-date with all-new literature searches and value determinations supplementing each one bankruptcy Full-color layout with dynamic medical illustrations and pictures Real-world specialise in a selected scientific query in each one bankruptcy, reflecting the best way clinicians process the perform of evidence-based medication greater than 50 entire chapters on universal and not easy scientific questions and sufferer displays Not-to-be-missed assurance of the foundations of evidence-based drugs and actual analysis, with the ideas of specificity and sensitivity utilized to the sufferer come upon additionally to be had: JAMAevidence.com, a brand new interactive database for the easiest perform of proof established drugs (20081118)
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Extra resources for The Rational Clinical Examination: Evidence-Based Clinical Diagnosis (Jama & Archives Journals)
Most of the important biases that compromise a study’s results follow from the study population not being consecutive, prospective, or independently assessed with an appropriate blindly applied reference standard. By consecutive, we mean that the authors enrolled all patients for whom the target disorder was a reasonable consideration. Independent means that the symptom or sign under study was not used to select patients for the study. Blind means that the symptoms and signs were applied without knowledge of the presence of disease determined by the reference standard, but also that the reference standard was interpreted without knowledge of the study questions.
2003;56(11):1129-1135. 2. Simel DL, Samsa GP, Matchar DB. Likelihood ratios with conﬁdence: sample size estimation for diagnostic test studies. J Clin Epidemiol. 1991;44(8):763-770. 3. Hasselblad V, Hedges LV. Meta-analysis of screening and diagnostic tests. Psychol Bull. 1995;117(1):167-178. 4. Devillé WL, Buntix F, de Vet R, Ligmer J, Montori V. Guidelines for conducting systematic reviews of studies evaluating the accuracy of diagnostic tests. In: Knotterus JA, ed. The Evidence Base of Clinical Diagnosis.
Does the clinical examination predict airﬂow limitation? JAMA. 1995;273(4):313-319. *Veriﬁcation bias can work in the opposite direction, although that is not usually the case. C H A P T E R 2 Does This Patient Have Abdominal Aortic Aneurysm? Frank A. Lederle, MD David L. Simel, MD, MHS CLINICAL SCENARIOS CASE 1 A 60-year-old man requests a physical examination because a friend recently died suddenly from a ruptured abdominal aortic aneurysm (AAA). Your examination reveals nothing abnormal. After reassuring the patient, you are left wondering whether you might have missed an AAA large enough to warrant surgical repair.