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Articles matching the ‘Diagnosis’ Category

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November 10th, 2012

Podcast 159: Making the Clinical Diagnosis, But Blowing the Patient’s Treatment Preference

Running time: 20 min. In some diseases there are two diagnoses to make: the clinical diagnosis and the diagnosis of what the patient’s treatment preference is. The first is hard enough to make, and the widening choice of treatment choices complicates the second. Welcome to the task of “preference diagnosis,” which can lead to […]


January 20th, 2012

Podcast 142: Really, why are you ordering that test?

The American College of Physicians wants to encourage high-value, cost-conscious care. And so they convened a consensus panel of physicians to list tests that they considered overused or inappropriately used in certain circumstances. One example would be the use of MRI for breast screening in normal-risk patients; another is the use of imaging studies […]


March 25th, 2011

Podcast 116: What do more sensitive troponin measurements mean for diagnosing ACS?

Troponin I levels can now be measured much more accurately and assays have a greater sensitivity. In Edinburgh, the diagnostic level for acute coronary syndrome was lowered from 0.20 ng/mL to 0.05. As a result, when patients presented with suspected ACS they were more likely to be diagnosed — and a year later were […]


June 25th, 2010

Podcast 93: Is computed tomography safe? Yes, but …

That’s the question asked in an intriguing essay — by a radiologist — released online in the New England Journal of Medicine. We have her as our guest this week. Feedback, please! You can comment here or by emailing me at jelia@jwatch.org — or better still, call 1-617-440-4374. Interview-related links: Rebecca Smith-Bindman’s essay Radiation […]


February 27th, 2010

Podcast 76: On saying “No” to patients’ requests.

A conversation with the authors of an Archives of Internal Medicine study that examines the best tactics for saying “No” to inappropriate requests. Contact me at 1-617-440-4374 or at jelia@jwatch.org. Interview-related links: Archives of Internal Medicine abstract Atul Gawande’s New Yorker article News-related links: The rosiglitazone (Avandia) controversy Advisory on thiazolidinediones Physicians’ work hours 13-valent […]


May 17th, 2009

Podcast 43: An interview with Martha Gulati on her research into the cardiovascular risks faced by symptomatic women who have normal angiograms.

Northwestern’s Martha Gulati has just published a paper in Archives of Internal Medicine about the hazards of treating symptomatic women with normal angiograms as if they had a benign prognosis. We’ll talk with her after a look at the news, and a reminder that you can really help Clinical Conversations with your feedback. The place […]


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