Rational Diagnosis And Treatment

Now in its fourth edition, Rational Diagnosis and Treatment: Evidence-Based Clinical Decision-Making is a unique book to look at evidence-based medicine and the difficulty of applying evidence from group studies to individual patients. The book analyses the successive stages of the decision process and deals with topics such as the examination of the patient, the reliability of clinical data, the logic of diagnosis, the fallacies of uncontrolled therapeutic experience and the need for randomised clinical trials and meta-analyses. It is the main theme of the book that, whenever possible, clinical decisions must be based on the evidence from clinical research, but the authors also explain the pitfalls of such research and the problems involved in applying evidence from groups of patients to the individual patient. For this new edition, the sections on placebo and meta-analysis and on alternative medicine have been thoroughly updated, and there is more focus on insufficient reporting of harms of interventions. The sections on different research designs describe advantages and limitations, and the increased medicalisation and the effects of cancer screening on health people are noted. A section on academic freedom when clinicians collaborate with industry and ghost authors is added. This essential reference work integrates the science and statistical approach of evidence-based medicine with the art and humanism of medical practice; distinguishing between data, sets of data, knowledge and wisdom, and their application. Such an intellectually challenging book is ideal for both medical students and doctors who require theoretical and practical clinical skills to help ensure that they apply theory in practice.

The ultimate guide to the evidence-based clinical encounter "This book is an excellent source of supported evidence that provides useful and clinically relevant information for the busy practitioner, student, resident, or educator who wants to hone skills of physical diagnosis. It provides a tool to improve patient care by using the history and physical examination items that have the most reliability and efficiency."--Annals of Internal Medicine "The evidence-based examination techniques put forth by Rational Clinical Examination is the sort that can be brought to bear on a daily basis – to save time, increase confidence in medical decisions, and help decrease unnecessary testing for conditions that do not require absolute diagnostic certainty. In the end, the whole of this book is greater than its parts and can serve as a worthy companion to a traditional manual of physical examination."--Baylor University Medical Center (BUMC)Proceedings 5 STAR DOODY'S REVIEW! "Physical diagnosis has been taught to every medical student but this evidence-based approach now shows us why, presenting one of medicine's most basic tenets in a new and challenging light. The format is extraordinary, taking previously published material and updating the pertinent evidence since the initial publication, affirming or questioning or refining the conclusions drawn from the data. "This is a book for everyone who has studied medicine and found themselves doubting what they have been taught over the years, not that they have been deluded, but that medical traditions have been unquestionably believed because there was no evidence to believe otherwise. The authors have uncovered the truth. "This extraordinary, one-of-a-kind book is a valuable addition to every medical library."--Doody's Review Service Completely updated with new literature analyses, here is a uniquely practical, clinically relevant approach to the use of evidence in the content of physical examination. Going far beyond the scope of traditional physical examination texts, this invaluable resource compiles and presents the evidence-based meanings of signs, symptoms, and results from physical examination maneuvers and other diagnostic studies. Page after page, you'll find a focus on actual clinical questions and presentations, making it an incomparably practical resource that you'll turn to again and again. Importantly, the high-yield content of The Rational Clinical Examination is significantly expanded and updated from the original JAMA articles, much of it published here for the first time. It all adds up to a definitive, ready-to-use clinical exam sourcebook that no student or clinician should be without. FEATURES Packed with updated, new, and previously unpublished information from the original JAMA articles Standardized template for every issue covered, including: Case Presentation; Why the Issue Is Clinically Important; Research and Statistical Methods Used to Find the Evidence Presented; The Sensitivity and Specificity of Each Key Result; Resolution of the Case Presentation; and the Clinical Bottom Line Completely updated with all-new literature searches and appraisals supplementing each chapter Full-color format with dynamic clinical illustrations and images Real-world focus on a specific clinical question in each chapter, reflecting the way clinicians approach the practice of evidence-based medicine More than 50 complete chapters on common and challenging clinical questions and patient presentations Also available: JAMAevidence.com, a new interactive database for the best practice of evidence based medicine

Written specifically for non-infectious disease specialists in both inpatient and outpatient settings, A Rational Approach to Clinical Infectious Diseases provides concise, practical guidance that mimics the decision-making process and reasoning employed by an ID physician. Using clear, understandable language, Dr. Zelalem Temesgen and his esteemed colleagues at the Mayo Clinic present the art and the context of infectious diseases together with the science, helping non-specialists apply a rational approach to the diagnosis and treatment of infectious conditions. Clearly explains the rationale of opting for one particular treatment or length of course over another in order to arrange appropriate management and follow-up. Provides focused ID decision support to questions such as: What diagnostic test should I order? What is the correct antibiotic for this patient/geographical region? Are IV or oral antibiotics most appropriate? How long should the antibiotic course be and when should it be de-escalated? What special considerations should be taken in immunocompromised patients? How often should complex infections be followed up? Uses a succinct, easy-to-read writing style, following a consistent format: Important characteristics/epidemiology; Clinical related data; Rash characteristics; Ancillary diagnostic studies; Treatment; and Other. Provides visual and quick-reference support with dozens of figures and tables throughout the text. Contains invaluable guidance to help non-specialists provide the best care for patients, stem antibiotic misuse and resistance, avoid adverse drug events, and avoid unnecessary costs.

Peripheral neuropathies represent a challenging subject for most physicians. This is an up-to-date, comprehensive, and readable book on peripheral neuropathies that includes concise information on the clinical, electrophysiological, pathological, pathogenic, and treatment aspects of the most important disorders. New molecular and serologic diagnostic tests are discussed. Sections are devoted to nerve and skin biopsy techniques and findings, quantitative sensory and autonomic reflex tests. Case examples are used liberally throughout the text. The editors: Mendell, Kissel, and Cornblath are experienced clinicians that bring complementary knowledge to each of the subjects. Additional authors have been handpicked for specific topics which add to the value of the edition.

Jeanne Daly traces the development of evidence-based medical practices from the 1970s until the present day.