Walter Ageno1; Francesco Dentali1; Alessandro Squizzato1; Trevor Baglin2; James Douketis3; Martin Lansberg4; Maurizio Paciaroni5; Gualtiero Palareti6 1Department of Clinical Medicine, University of Insubria, Varese, Italy; 2Department of Hematology, Cambridge University, Cambridge, UK; 3Department of Medicine, McMaster University, Hamilton, Canada; 4Stanford Stroke Center, Stanford University M...

Pneumonia is often diagnosed and treated empirically. We set out to determine the diagnostic accuracy of clinical judgment based on signs and symptoms to detect radiographic pneumonia in patients presenting with acute cough in primary care. In 2810 European patients with acute cough, general practitioners (GPs) recorded whether they considered pneumonia to be present ("yes" or "no") immediately...

Reflection is widely used in nursing education to facilitate learning. Student writing and thinking, however, is not always of the quality faculty expect or desire. This project originated from concern about the quality of student descriptions of clinical experiences in a senior-level precepted clinical practicum. Providing students with more structure and guidance for consideration of clinical...

When I graduated, it was accepted wisdom that lameness was assessed by watching horses move in hand. As an experienced rider, I became increasingly aware of the value of ridden exercise to assess lameness and performance. This has become an essential part of lameness and poor performance diagnosis. Diagnostic analgesia is now commonplace, but it is only comparatively recently that we have becom...

A 51-year-old woman with a history of mild hypertension and mild hyperlipidemia presented with a 2-h episode of substernal chest discomfort for the first time. She was receiving a statin but refused treatment for hypertension. She was an avid runner and had never had chest discomfort previously. The discomfort occurred at rest and radiated to her arms and her neck. Her electrocardiogram reveale...

Psychiatrists who work in inpatient units are faced with daily decisions about predicting which patients will be violent, both in the hospital and after discharge. These decisions are often made using unstructured clinical judgment based on the clinician's experience and knowledge of the literature. How long such judgment stays the standard of care remains to be seen, because psychiatric resear...