NEJM Clinical Problem Solving (New England Journal of Medicine)

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9780071471626: NEJM Clinical Problem Solving (New England Journal of Medicine)

Expert clinical problem-solving methods and guidance—from the editors and contributors of The New England Journal of Medicine

This invaluable resource from the New England Journal of Medicine expertly addresses methods and challenges in clinical diagnosis. Including the peer-reviewed content of the NEJM’s renowned “Clinical Problem Solving” feature, this powerful resource is packed with case discussions from both ambulatory and hospital practice.

Each Case Presentation reveals thought-provoking clinical and laboratory clues as the diagnostic considerations begin to emerge. Subsequent clinical detail and discussion and expert analysis add to the diagnostic picture until a final clinical diagnosis is reached.

New England Journal of Medicine: Clinical Problem-Solving features:

  • Published cases drawn from the New England Journal of Medicine reflecting actual patient-management situations that physicians experience in their everyday clinical practice
  • Two brand new, never-before-published chapters on medical decision-making skills and methods
  • Wide-ranging coverage of the major considerations in each case, from underlying pathophysiology to signs from the physical examination to lab testing strategies
  • More than 100 full-color illustrations, tables, and algorithms
  • Meticulously selected references that open up avenues for further study
  • And much more!

    From cover to cover, New England Journal of Medicine: Clinical Problem-Solving presents the best case analysis, diagnostic thought processes, and problem-solving - direct from master clinicians.

  • "synopsis" may belong to another edition of this title.

    Review:

    "The book includes 22 fascinating cases initially published in the journal's series. Each case is gradually revealed in a real life situation. Expert commentary provides insight into the diagnostic process. These cases are so memorable that they will undoubtedly be useful to clinicians in practice...This compilation of clinical problem-solving cases provides an enjoyable way to learn medicine."-- Doody's Review Service ( Doody's 2007-02-09)

    "This text uses real cases published in The New England Journal of Medicine to illustrate how clinicians in both ambulatory and hospital practice reach decisions regarding diagnosis and treatment. The volume opens with an overview of the techniques of quantitative medical decision-making, followed by a discussion of the mental functions that underlie the diagnostic process. Each case presents patient information in small increments to experienced clinicians who then share their reasoning with the reader. Students may opt to initially skip over the expert commentary and instead use the cases to test their own diagnostic skills."-- Sci-Tech Book News ( Sci-Tech Book News 2006-09-01)

    About the Author:

    Sanjay Saint,MD, MPH is Associate Professor of Medicine, University of Michigan School of Medicine

    Jeffrey Drazen, MD is editor and chief of NEJM and Professor of Medicine at Harvard Medical School

    Caren Solomon, MD, MPH is Deputy Editor of NEJM and Associate Professor of Medicine, Harvard Medical School

    "About this title" may belong to another edition of this title.

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    Saint, Sanjay; Drazen, Jeffrey M.; Solomon, Caren G
    Published by McGraw-Hill Professional (2006)
    ISBN 10: 0071471626 ISBN 13: 9780071471626
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    Saint, Sanjay; Drazen, Jeffrey M.; Solomon, Caren G
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    Saint, Sanjay; Drazen, Jeffrey M.; Solomon, Caren G
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    Saint, Sanjay; Drazen, Jeffrey M.; Solomon, Caren G
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    Saint, Sanjay; Drazen, Jeffrey M.; Solomon, Caren G
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    Book Description McGraw-Hill Professional, 2006. Book Condition: New. Brand New, Unread Copy in Perfect Condition. A+ Customer Service! Summary: Preface One of the joys of medicine is learning how to think through challenging clinical problems. Our book is aimed at those who want to become better diagnosticians as well as those who simply enjoy working through a diagnostic problem to eventually arrive at the answer. These challenges include generating an appropriate initial list of differential diagnoses based on a patient''s presenting signs and symptoms; modifying this initial list to reflect the information gleaned from the history, physical examination, and standard laboratory tests; identifying appropriate additional tests or historical information needed to reach the diagnosis; and determining when the information obtained is sufficient to make a provisional or a final diagnosis and to justify beginning therapy. Students and resident physicians have traditionally acquired these skills by working alongside and under the supervision of experienced clinicians, who provide guidance as a patient''s presenting symptoms and signs are addressed. When patients remained in the hospital for long periods, students and residents had the opportunity to follow them from presentation through diagnosis and beyond. As a result of dramatic changes in health care delivery and medical education with patients being discharged more quickly and with students and residents having mandatory days off there are fewer opportunities for students and residents to engage in the full process of problem-solving that eventually yields the correct diagnosis. Yet students and residents need as much as ever to understand how seasoned and expert clinicians confront clinical problems. For example, we have observed that skilled clinicians often keep two lists of potential diagnoses active in their mind as they consider a patient''s problems. The first list contains, usually in rank order, the most likely diagnoses that can account for the patient''s complaint. This list is initially generated from the history of the present illness, the past medical and social history, the physical examination, and the initial data obtained. As new data are obtained, the rank order is modified. Some who have just begun their clinical training may, unfortunately, not go beyond this point. Knowledgeable clinicians, on the other hand, realize that considering only the most likely disorders may lead to missed diagnoses and ultimately to patient harm. For this reason, master clinicians compile a second list that contains those diagnoses however unlikely that could cause the patient to die or to decompensate quickly. Although usually not all of the diagnoses on this additional list are pursued by advanced diagnostic testing, the clinician searches carefully for any clues in the history, physical examination, or initial diagnostic evaluation that require further pursuit. Our book is divided into two sections. In the first, we provide an overview of the decision science underlying the art of clinical decision-making. "Quantitative Medical Decision-Making", provides a quantitative approach to making clinical decisions, including an overview of Bayesian decision-making, thresholds for taking action (diagnostic and therapeutic), and test characteristics such as sensitivity, specificity, and likelihood ratios. Complementing the quantitative approach to solving clinical problems, the next chapter, "Clinical Decision-Making: Understanding How Clinicians Make a Diagnosis," provides the reader with an overview of important concepts in cognitive psychology that to a large extent explain how clinicians make diagnoses. Various types of heuristics (or "mental shortcuts") and biases are defined, discussed, and illustrated with examples. Clinicians learn best from patients. Thus, the rest of the book is devoted to clinical examples. The remaining chapters describe real cases previously peer-reviewed and published in the "Clinical Problem-Solving" series of the New Eng. Bookseller Inventory # ABE_book_new_0071471626

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