Learning Clinical Reasoning

Cover
Learning Clinical Reasoning, Second Edition
Copyright
Dedication
Foreword
Preface to the Second Edition
Acknowledgments
A Note About the Book’s Format
Contents
Part I: The Processes of Clinical Reasoning
	Chapter 1: Overview
		Introduction
		Diagnosis is an Inferential Process
		Problem-Solving Strategies
		Diagnosis Based on Hypothesis Generation and Testing
		Alternate Concepts of Diagnostic Strategies
		Linking Diagnosis and Treatment
	Chapter 2: Diagnostic Hypothesis Generation
		Hypotheses and Cues
		The Cognitive Basis of Hypothesis Generation
		Hypotheses as a Context
		Expertise and Error
	Chapter 3: Refinement of Diagnostic Hypotheses
		Where Refinement Begins and Ends
		Context and Diagnostic Classification
		Hypothesis Evolution
		Sequence of Data Collection
		Reducing Diagnostic Uncertainty
		The Differential Diagnosis
		Relation to Formal Probabilistic Approach
	Chapter 4: Use and Interpretation of Diagnostic Tests
		The Function of Tests
		Quantifying Testing Decisions
		Sensitivity and Specificity
		Bayes' Rule
		Testing Principles
		Bayesian Revision for Multiple Results
		Bayesian Revision for Multiple Diseases With Multiple Attributes
		Pragmatic Considerations in the Probabilistic Approach
		Interpreting Results
		When to Test
		The Threshold Concept
		The Therapeutic Threshold
		Testing Thresholds
	Chapter 5: Causal Reasoning
		Definition
		Using a Causal Model
		Where in the Diagnostic Process Does Causal Reasoning Fit?
		Explaining Relations Between Variables
	Chapter 6: Diagnostic Verification
		Definition
		Criteria of Validity
		Premature Closure
		The Penultimate Result: A Working Diagnosis
	Chapter 7: Therapeutic Decision Making
		Principles
		Treatment Under Conditions of Uncertainty
		When the Value of Therapeutic Choices is Close
		Incommensurate Options
		Quantitative Therapeutic Decision Making
	Chapter 8: Examining Evidence
		Introduction
		Evidence-Based Medicine
		Asking Questions
		Searching for Evidence
		Summarizing and Appraising Evidence
		Applying the Evidence
		Practice Guidelines
	Chapter 9: Cognitive Errors
		Scope
		Classification
		Some Errors may have a Psychological Origin
		The Nature of Cognitive Errors
		Cognitive Biases in the Laboratory
		Consequences of Cognitive Biases
		Strategies for Avoiding Cognitive Errors
	Chapter 10: Some Cognitive Concepts
		Cognitive Science
		Studying Mental Processes
		The Structure of Memory
		Search Strategies
		Characteristics of Expertise
	Chapter 11: Learning Clinical Problem Solving
		Facts Versus Process
		Pedagogic Principles
		A Specific Example
		The Goal Should Determine the Format
		Learning by Instantiation
		Learning Clinical Problem Solving Versus Problem-Based Learning
Part II: Cognition at the Bedside: A Set of Examples
	Chapter 12: Introduction to the Cases
	Chapter 13: Diagnostic Hypothesis Generation
		Case 1. Generation of Diagnostic Hypotheses
		Case 2. Hypothesis Triggering by an Expert
		Case 3. A Diagnostic Coup
		Case 4. A Quick and Accurate Solution
		Case 5. Better Late Than Never
		Case 6. A Hit After a Miss
		Case 7. The Critical Role of Context in the Diagnostic Process
		Case 8. A Masked Marauder*
		Case 9. A Serious Lack of Focus
	Chapter 14: Refinement of Diagnostic Hypotheses
		Case 10. What is a Differential Diagnosis?
		Case 11. An Orderly, Sequential Approach
		Case 12. Weak Reasoning: Diagnosis by Drug Reaction*
		Case 13. Narrowing Down the Diagnostic Options
		Case 14. A Picture is Worth a Thousand Words
		Case 15. Strategies of Information Gathering
		Case 16. A Fatal Flaw in Sutton's Law
		Case 17. How to Disregard Red Herrings
		Case 18. Discrimination: The Problem of Look-Alikes
		Case 19. Location, Location, Location
	Chapter 15: Use and Interpretation of Diagnostic Tests
		Case 20. Interpreting a Negative Test Result
		Case 21. Diagnosis and the Risks of the Primrose Path
		Case 22. Searching for a Pony
		Case 23. Interpreting Hoofbeats: Can Bayes Help Clear the Haze?*
		Case 24. Short-Circuiting the Diagnostic Process
		Case 25. The Bypass on the Way to the Bypass
		Case 26. It is What You Believe That Counts
		Case 27. Renal Rescue by Reverend Bayes
		Case 28. A Diagnostic Fluke
		Case 29. Surprise!
		Case 30. Tripping Over Technology
		Case 31. The Probability of a Probability
	Chapter 16: Causal Reasoning
		Case 32. Judging Causality
		Case 33. Post Hoc, Ergo Propter Hoc
		Case 34. The Case for Causal Reasoning
		Case 35. The Tricky Task of Attributing Causation
		Case 36. The Right Answer for the Wrong Reason
	Chapter 17: Diagnostic Verification
		Case 37. A Point-By-Point Dissection of Clinical Reasoning
		Case 38. Leaving No Stone Unturned
		Case 39. Verification
		Case 40. A Meticulous Approach
		Case 41. A Diagnostic Quandary
		Case 42. Diagnosis by Fiat
		Case 43. Iron Pyrite and Diagnostic Confirmation
	Chapter 18: Therapeutic Decision Making
		Case 44. The Surgeon Opts to Operate: Why?
		Case 45. Treat or Keep Testing?
		Case 46. Watch and Wait, or Operate?
		Case 47. An Apple or an Orange?
	Chapter 19: Examining Evidence
		Case 48. A Difficult Tradeoff
		Case 49. Making Judgments When the Evidence is Not Definitive
		Case 50. Using and Citing Published Evidence
		Case 51. A Little Math Makes the Medicine Go Down*
		Case 52. A Rewarding Pursuit of Certainty*
		Case 53. Treating Before Knowing*
	Chapter 20: Cognitive Errors
		Case 54. A Defective Detective
		Case 55. Remedies for Faulty Hypothesis Generation
		Case 56. A Disaster Averted
		Case 57. Derailed by the Availability Heuristic
		Case 58. Wrong Diagnosis, Wrong Tests, Wrong Treatment
		Case 59. Reconsidering Failures of Therapy
		Case 60. The Cheetah and the Snail
		Case 61. A Collection of Cognitive Diagnostic Errors
	Chapter 21: Some Cognitive Concepts
		Case 62. A Message about Methods
		Case 63. Memory: How We Overcome its Limitations
		Case 64. Diagnosis and the Structure of Memory; Disease Polymorphism and Mental Models
		Case 65. Intuitive and Inspirational, or Inductive and Incremental?
		Case 66. Knowledge and Clinical Expertise
	Chapter 22: Learning Clinical Problem Solving
		Case 67. Learning Clinical Reasoning from Examples
		Case 68. Making a Silk Purse out of a Sow's Ear
		Case 69. Optimizing Case Discussions
Glossary
Bibliography
Index