1 / 60

Medical Decision-Making

Medical Decision-Making. Keith Bradley, MD Director Research Associates Program at St. Vincent’s National Alliance of RA Programs. Three (3) Modes of Diagnosis. Pattern Recognition (“Augenblick”) Branching Matching. Augenblick. “blink of an eye” See it; know it. ABC’s. A = asymmetric

teagan
Télécharger la présentation

Medical Decision-Making

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Medical Decision-Making Keith Bradley, MD Director Research Associates Program at St. Vincent’s National Alliance of RA Programs

  2. Three (3) Modes of Diagnosis • Pattern Recognition (“Augenblick”) • Branching • Matching

  3. Augenblick “blink of an eye” See it; know it

  4. ABC’s • A = asymmetric • B = border irregular • C = color black or variable • D = diameter > 1/4”

  5. Branching

  6. Branching e.g., Chest Pain

  7. Branching e.g., Chest Pain • “expert”

  8. Branching e.g., Chest Pain • “expert” • “blinders”

  9. Branching e.g., Chest Pain • “expert” • “blinders” •  potential for error

  10. Branching e.g., Chest Pain • “expert” • “blinders” •  potential for error • “practice”

  11. Matching

  12. Matching • ALL possible diagnoses on x-axis

  13. Matching • ALL possible diagnoses on x-axis • Each possible • symptom • sign on y-axis • investigation result

  14. Matching • ALL possible diagnoses on x-axis • Each possible sx, px, tx on y-axis • = Excel spreadsheet

  15. Matching • ALL possible diagnoses on x-axis • Each possible diagnoses on y-axis • = Excel spreadsheet • Lawrence Weed, MD / “couplers”

  16. Different Types of Problems  Different Types of Responses

  17. Non-Traumatic Unconsciousness

  18. Non-Traumatic Unconsciousness • Airway

  19. Non-Traumatic Unconsciousness • Airway • Breathing

  20. Non-Traumatic Unconsciousness • Airway • Breathing • Circulation

  21. Non-Traumatic Unconsciousness • Airway • Breathing • Circulation • Defibrillate

  22. Types of Problems  Types of Responses ProblemResponse Acute  Rapid, simple, memorized

  23. Fever, Ear Pain in a 3 year old

  24. Fever, Ear Pain

  25. Fever, Ear Pain

  26. Fever, Ear Pain • Dx = acute otitis media • Tx = depending on timing: nothing or Abs

  27. Types of Problems  Types of Responses ProblemResponse Acute  Rapid, simple, memorized Routine  Routine, stylized

  28. “My leg is swollen”

  29. “My leg is swollen” • What would Dr. House do?

  30. “My leg is swollen” • What would Dr. House do? • DDx

  31. “My leg is swollen” • What would House do? • DDx • Key Question … never forget to ask = ?

  32. “My leg is swollen” • What would House do? • DDx • Key Question … never forget to ask • Be the star!

  33. “My leg is swollen” • What would House do? • DDx • Key Question … never forget to ask • Be the star! • thick smear … draw blood at night

  34. “My leg is swollen” • Dx = filiariasis

  35. “My leg is swollen” • Dx = filiariasis • Tx = anti-helminths or …

  36. “My leg is swollen” • Dx = filiariasis • Tx = anti-helminths or … • The parasites responsible for filariasis have a population of symbiotic bacteria, Wolbachia, that live inside the worm. • When the symbiotic bacteria are killed by the antibiotic, the worms themselves also die. • Doxycycline might be effective • Clinical trials in June 2005 by the Liverpool School of Tropical Medicine reported that an 8 week course almost completely eliminated microfilariaemia.[4][5]

  37. Types of Problems  Types of Responses ProblemResponse Acute  Rapid, simple, memorized Routine  Routine, stylized Unique  Unique

  38. MVC, Multiple Trauma

More Related