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The Rational Clinical Examination – Evidence-Based Clinical Diagnosis
Author: David L Simel, Marvin Nelson
Publisher: McGraw-Hill Medical
This excellent book features a series of peer-reviewed articles on history taking and clinical examination that have been published in the Journal of the American Medical Association since 1992.
Each article is presented in its original format, followed by a summary of new information.
This is a sizeable tome covering clinical conditions from osteoporosis to thoracic aortic dissection. Each chapter begins with a diagnostic question, for example: ‘Is this patient having a myocardial infarction?’
The clinical scenarios are engaging, with each article illustrating the most relevant signs and symptoms, such as pain. The emphasis on clinical significance and recognition that clinical examination is an art and science are particularly refreshing.
A useful primer chapter explains terms such as confidence, sensitivity, specificity and meta-analysis with reference to clinical examination, signs, symptoms and diagnostic tests.
The book acknowledges that those caring for patients will engage in history taking and clinical examination, and in so doing supports evidence-based practice.
Overall, this is a detailed and complex text supporting exploration of the decision-making process with reference to history and examination.
Reviewer: Pam Nelmes
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