Questioning clinical judgement

Treatment bias and clinical judgement.

Appendicitis : Clinical judgement and operative findings

Introduction Appendicitis is the most common intraabdominal disorder that requires emergency surgery, with a 6% lifetime risk. At the end of 20th Century, appendicitis still remains a clinical entity and an ongoing diagnostic dilemma as the presentation may be atypical. Recent literature reports rates of normal appendix removal ranging from 9% to 40%. These results are not different from earlie...

Clinical judgement and the medical profession

OBJECTIVES Clinical judgment is a central element of the medical profession, essential for the performance of the doctor, and potentially generating information also for other clinicians and for scientists and health care managers. The recently renewed interest in clinical judgement is primarily engaged with its role in communication, diagnosis and decision making. Beyond this issue, the presen...

Clinical judgement, expertise and skilled coping.

Medicine involves specific practical expertise as well as more general context-independent medical knowledge. This raises the question, what is the nature of the expertise involved? Is there a model of clinical judgement or understanding that can accommodate both elements? This paper begins with a summary of a published account of the kinds of situation-specific skill found in anaesthesia. It a...

Data based medicine and clinical judgement.

Randomized controlled trials (RCTs) are a useful tool to check the effectiveness of drugs but have come to shape the culture of medicine in a manner that increasingly compromises medical care. Dependence on RCT evidence is compromised by the well-known problems stemming non-publication of trials, lack of access to trial data, ghostwriting of those trials that are published and a variety of codi...