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Index
COVER
HOSPITAL MEDICINE: CURRENT CONCEPTS
TITLE PAGE
COPYRIGHT PAGE
DEDICATION
PREFACE
ACKNOWLEDGMENTS
INTRODUCTION: SURVIVING AND THRIVING IN WARD WORLD
THREE KEY CHALLENGES FOR STUDENTS AND PRACTITIONERS
UNCOMPLICATING LIFE IN A COMPLEX WORLD
UNEXPECTED INNOVATION
PART 1: MEDICAL MUSTS AND MUST-NOTS: SIX ESSENTIALS OF WARD WORLD
CHAPTER 1 HOW (NOT) TO PRESENT A PATIENT HISTORY
THE HIDDEN HISTORY OF A HISTORY
ADVERSE EFFECTS
MINI-SUMMARY
CHAPTER 2 REEXAMINING THE PHYSICAL EXAM
PHYSICAL EXAM AND HYPOTHESIS TESTING
GENERAL APPEARANCE
REVITALIZING THE VITAL SIGNS
ADDITIONAL LAPSES IN REPORTING THE VITAL SIGNS
UNDER PRESSURE
FINDING HIDDEN INFORMATION IN VITAL SIGNS— MORE ADVANCED ANALYSIS
REPLACING SEMI- OR PSEUDOQUANTITATIVE MEASURES WITH MORE USEFUL QUALITATIVE MEASURES
INCREASING YOUR LEVEL OF CERTAINTY: INTERNAL CONFIRMATIONS
PHYSICAL EXAM: SEMANTIC AND SCIENTIFIC PRECISION
MINI-SUMMARY
CHAPTER 3 HOW (NOT) TO ORDER AND PRESENT LAB TESTS
“INCIDENTAL” FINDINGS
CLASSIFICATION OF BASIC LAB DATA
PRESENTATION OF LAB TESTS: THE TWO MAJOR PROBLEMS
CHECKING PRIMARY SOURCES VS. COPING WITH WORK (OVER) FLOW PRESSURES
MINI-SUMMARY
CHAPTER 4 SEEING IS (ALMOST) BELIEVING: THE IMPORTANCE OF REVIEWING DATA
UNEXPECTED SOURCES OF VARIABILITY
ASSESSING OBSERVER VARIABILITY
COMPUTER INTERPRETATIONS
COPING WITH OBSERVER VARIABILITY
A RELATED CAUTION: CUT-AND-PASTE WORKUPS
FINAL NOTE: WHEN SEEING AND BELIEVING DIVERGE
CHAPTER 5 “WORSTS FIRST”: HOW TO FRAME A DIFFERENTIAL DIAGNOSIS
DIFFERENTIAL DIAGNOSIS OF CHEST DISCOMFORT
DIFFERENTIAL DIAGNOSIS OF RIGHT UPPER QUADRANT PAIN
“n-PLUS”: A FINAL NOTE ON CRAFTING DIFFERENTIAL DIAGNOSES
MINI-SUMMARY
CHAPTER 6 CLINICAL QUERIES: ASKING THE 3½ KEY QUESTIONS
GLIMPSE VS. GAZE: WHAT THINKING MODE TO PRESCRIBE ON THE WARDS
THE 3½ KEY QUESTIONS RULE
BEYOND THE 3½ KEY QUESTIONS
MINI-SUMMARY
PART 2: MEDICAL MASTERIES
CHAPTER 7 E = MC3: ERROR REDUCTION EQUALS MOTIVATION TIMES COMMUNICATION TO THE POWER OF 3
DEFINING MEDICAL ERRORS: DO WE KNOW THEM WHEN WE SEE THEM?
THE FLIP SIDE
ERRORS THAT FLY BELOW THE RADAR
BACK TO THE INDEX CASE
ROUNDING UP ERRORS
MINI-SUMMARY
CHAPTER 8 EVIDENCE-BASED MEDICINE: WHAT AND WHERE IS THE EVIDENCE?
CLINICAL USE OF EBM
THE NEED TO LOOK AT DATA CRITICALLY
A NEW PARADIGM?
LIMITATIONS OF RCTs
EVIDENCE-BASED MEDICINE AND MEDICAL SCIENCE: FINAL CAVEATS
EVIDENCE-BASED MEDICINE: CLINICAL INERTIA AND EXIT BLOCK SYNDROMES
MINI-SUMMARY
CHAPTER 9 CAUTION! DANGEROUS BIOMEDICAL SEMANTICS AT WORK
SEMANTIC BIAS AND THE DRUGS YOU PRESCRIBE
SEMANTIC BIAS AND TARGETED THERAPIES
OFF-TARGET EFFECTS
SEMANTIC BIOCHEMICAL BIAS
HOMEOSTASIS REVISITED
IS THE BODY A SERVOMECHANISM TYPE OF MACHINE?
MINI-SUMMARY
CHAPTER 10 SOME SECOND OPINIONS: OUTLIERS, HOOFBEATS, AND SUTTON’S (FLAWED) LAW
OUTLIERS: CLUES OR RUSE?
EQUINE HOOFERS AND BANK LARCENY: TIME TO RETIRE TWO OUTMODED CLINICAL “PEARLS”?
ETIOLOGIES AND APPLICATIONS
MINI-SUMMARY
CHAPTER 11 A SIXFOLD PATH: FROM DATA TO KNOWLEDGE TO UNDERSTANDING
THE NAUTILUS AND THE SPIRAL CURVE OF LEARNING
“PATHO-PHYS,” NOT “PATHO-LISTS”
SALTATION: LEARNING BY LEAPS AND BOUNDS
SKETCHING: THE ART OF LEARNING MEDICINE
MULTISOURCING
TEACHING: THE ESSENTIAL PATH TO LEARNING AND MASTERY
MINI-SUMMARY
CHAPTER 12 WHAT IS DISEASE? WHAT IS HEALTH?
WHAT IS A DISEASE?
AGING AND DISEASE
PRIMARY DISEASE VS. INADVERTENT INJURY
INTERNAL STRESS AND DISEASE: THE CAREGIVER SYNDROME
EXTERNAL STRESS AND DISEASE
DEFINING DISEASE AND HEALTH: ALTERNATIVE APPROACHES
WHAT IS HEALTH?
IMPLICATIONS: GENERAL AND SPECIFIC
SYNDROMES WITHIN SYNDROMES
A SELF-CHALLENGE
MINI-SUMMARY
BIBLIOGRAPHY AND NOTES
INDEX
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