Evidence-Based Diagnosis: A Handbook of

What is the probability that a patient with a sore throat has strep? How about the likelihood of DVT in a patient with leg symptoms? What is the prognosis for patients with melanoma, pneumonia, or breat cancer?Covering a full range of topics from cardiovascular and pulmonary disease to ophthalmology, hematology and pediatrics, EVIDENCE-BASED DIAGNOSIS is the only single volume, quick reference designed for use in daily practice. Containing over 150 clinical prediction rules as well as need-to-know background information on each rule to determine its validity and relevance for your practice, these rules are essential for every physician in a time of limited health care resources. Designed as an aid in diagnosis and treatment, clinical prediction rules will allow you to make more accurate diagnosis and treatment decisions while eliminating superfluous testing.As an added bonus, a CD-ROM with software designed by the author is included with this volume. The software is designed to allow you to calculate clinical prediction rules with the ease and convenience of the computer. Simply check the boxes, click enter and receive the probabilities.Mark H. Ebell, M.D., M.S. is Associate Professor in the Department of Family Practice at Michigan State University. He is editor of the "Journal of Family Practice" and coeditor of the "Evidence-Based Practice" newsletter, and is the author of over 80 peer-reviewed publications.

Mark H. Ebell, M.D., M.S. is Associate Professor in the Department of Family Practice at Michigan State University.

Using Clinical Prediction Rules in Your Practice

1

(13)

Clinical Prediction Rules and Evidence-Based Medicine

2

(1)

Organization of Each Chapter

3

(2)

Statistics

5

(5)

Sensitivity and Specificity

5

(1)

Positive and Negative Predictive Values

6

(1)

Likelihood Ratios

6

(1)

Comparing Sensitivity, Specificity, Predictive Value, and Likelihood Ratios

7

(1)

Receiver-Operating Characteristic Curves

8

(1)

Misclassification Rate

9

(1)

A Final Note

10

(1)

References

11

(2)

Cardiovascular Disease

13

(94)

Chest Pain

13

(11)

Diagnosis of Acute Cardiac Ischemia Using the Acute Cardiac Ischemia-Time Insensitive Predictive Index (ACI-TIPI)

13

(3)

Which Patients with Acute Chest Pain Require Intensive Care

16

(2)

Identification of Low-Risk Patients with Chest Pain

18

(2)

Acute Chest Pain and Normal or Nonspecific ECG (Identification of Low-Risk Patients)

20

(2)

Ruling out Myocardial Infarction in 12 Hours

22

(2)

Myocardial Infarction

24

(13)

Diagnosis of Inferior Wall Myocardial Infarction

24

(2)

Diagnosis of Myocardial Infarction in Patients with Left Bundle Branch Block

26

(2)

Diagnosis of Non-Q Wave MI

28

(2)

Mortality Associated with Acute Myocardial Infarction

30

(2)

Prognosis for AMI Based on Initial ECG

32

(3)

Diagnosis of Myocardial Infarction in the Emergency Department

35

(2)

Heart Murmurs

37

(6)

Evaluation of a Systolic Murmur

37

(2)

Predictors of Survival after Aortic Valvuloplasty

39

(2)

Aortic Stenosis and Aortic Valve Replacement

41

(2)

Peripheral Vascular Disease

43

(3)

Diagnosis of Peripheral Vascular Disease: Edinburgh Claudication Questionnaire

43

(3)

Cerebrovascular Disease

46

(10)

Risk of Stroke (Framingham Study)

46

(3)

Likelihood of Benefit from Carotid Endarterectomy

49

(3)

G-Score: Prognosis for Acute Stroke

52

(2)

Barthel Index for Stroke Rehabilitation

54

(2)

Coronary Artery Disease

56

(21)

Probability of CAD in Patients with Normal Resting ECG

56

(2)

Interpretation of Graded Exercise Tests

58

(2)

Probability of Complications after Coronary Angioplasty

60

(2)

Likelihood of Severe Coronary Artery Disease

62

(3)

In-hospital Mortality in Coronary Artery Bypass Surgery

65

(3)

Coronary Artery Disease Risk (Framingham Study)

68

(3)

Duke Treadmill Score (Interpretation of Graded Exercise Testing)

71

(2)

Likelihood of Significant Coronary Artery Disease Using the History and Physical Examination

73

(2)

Likelihood of Left Main Coronary Artery Disease Using the History and Physical Examination

75

(2)

Abdominal Aortic Aneurysm

77

(2)

Perioperative Mortality for Abdominal Aortic Aneurysm

77

(2)

Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism)

79

(10)

Diagnosis of Deep Vein Thrombosis

79

(2)

Risk of Thromboembolism in Patients with Nonvalvular Atrial Fibrillation

81

(2)

Diagnosis of Pulmonary Embolism I

83

(2)

Diagnosis of Pulmonary Embolism II

85

(2)

Risk of Bleeding Among Patients on an Anticoagulant

87

(2)

Congestive Heart Failure

89

(7)

ICU Prognosis for Patients with Congestive Heart Failure

89

(2)

Prognosis in Dilated Cardiomyopathy

91

(3)

Left Ventricular Ejection Fraction after MI

94

(2)

Preoperative Evaluation

96

(11)

Goldman's Cardiac Risk Index

96

(2)

Detsky's Modified Cardiac Risk Index

98

(3)

Cardiac Risk during Vascular Surgery

101

(3)

Morbidity and Mortality Following Cardiac Surgery

104

(3)

Critical Care

107

(20)

Mortality Prediction

107

(20)

APACHE II Score

107

(5)

Simplified Acute Physiology Score

112

(3)

Simplified Acute Physiology Score II (SAPS II)

115

(3)

Mortality and Length of Stay after Cardiac Surgery

118

(2)

Mortality Prediction Model

120

(3)

Probability of Death from Burn Injuries

123

(2)

Mortality Based on Number of Organ System Failures

125

(2)

Dermatology

127

(6)

Risk of Pressure Sores (Braden Scale)

127

(6)

Risk of Pressure Sores in Nursing Home Patients

127

(4)

Risk of Pressure Sores (Norton Scale)

131

(2)

Endocrinology

133

(6)

Metabolic Problems

133

(2)

Differential Diagnosis of Hypercalcemia

133

(2)

Diabetes Mellitus

135

(4)

Screening for Diabetes Mellitus

135

(2)

Insulin-Dependent or Non-Insulin-Dependent Diabetes Mellitus?

137

(2)

ENT/Ophthalmology

139

(4)

Cataract Surgery

139

(2)

Likelihood of Benefit from Cataract Surgery

139

(2)

Hearing Impairment

141

(2)

Hearing Handicap Inventory for the Elderly: Screening Version

141

(2)

Gastroenterology

143

(22)

Peptic Ulcer Disease and Dyspepsia

143

(3)

Ulcer in Patients with Dyspepsia

143

(3)

Gastrointestinal Hemorrhage

146

(10)

Likelihood of Gastrointestinal Bleeding in the Intensive Care Unit

146

(2)

Mortality Associated with Upper Gastrointestinal Bleeding

148

(2)

Adverse Events with Upper Gastrointestinal Hemorrhage

150

(2)

Mortality Due to Variceal Bleeding

152

(2)

Continued Upper Gastrointestinal Bleeding after Endoscopic Injection

154

(2)

Gallbladder and Pancreatic Disease

156

(9)

Likelihood of Common Bile Duct Lithiasis

156

(2)

Prognosis for Primary Biliary Cirrhosis

158

(2)

Ranson's Criteria for Acute Pancreatitis Severity

160

(2)

CT Severity Index for Acute Pancreatitis

162

(3)

Gynecology and Obstetrics

165

(12)

Obstetrics

165

(12)

Screening for Gestational Diabetes

165

(2)

Probability of Successful Vaginal Birth after Cesarian Birth (Validated)

167

(2)

Probability of Successful Vaginal Birth after Cesarian Birth (Unvalidated)

169

(2)

Successful Induction of Labor: Dhall Score

171

(2)

Successful Induction of Labor: Bishop Score

173

(2)

Predicting Success of External Cephalic Version

175

(2)

Hematology/Oncology

177

(32)

Thyroid Cancer

177

(2)

Thyroid Carcinoma Prognosis

177

(2)

Function/Performance Scales

179

(2)

Karnofsky Performance Scale

179

(2)

Lung Cancer

181

(6)

Prognosis for Inoperable Non-Small-Cell Lung Cancer

181

(2)

Prognosis for Terminal Lung Cancer

183

(2)

Prognosis for Inoperable Bronchogenic Lung Cancer

185

(2)

Breast Cancer

187

(9)

Risk of Breast Cancer (Gail Risk Model)

187

(3)

Risk of Breast Cancer Recurrence after Simple Mastectomy

190

(2)

Prognosis in Metastatic Breast Cancer

192

(2)

Long-term Outcome for Breast Cancer

194

(2)

Hepatocellular Carcinoma

196

(2)

Risk of Hepatocellular Carcinoma with Cirrhosis

196

(2)

Ovarian Cancer

198

(2)

Ovarian Cancer Prognosis

198

(2)

Hematologic Tumors

200

(2)

Multiple Myeloma

200

(2)

All Malignancies

202

(2)

Fever and Neutropenia in Cancer Patients

202

(2)

Dermatologic Malignancies

204

(2)

Prognosis for Melanoma

204

(2)

Coagulopathies

206

(3)

Bleeding Complications of Anticoagulant Therapy

206

(3)

Infectious Disease

209

(170)

Upper Respiratory Infections

209

(164)

Diagnosis of Streptococcal Pharyngitis (Dobbs' Bayesian Score)

209

(2)

Strep Score (Centor)

211

(3)

Sinusitis Score

214

(155)

Prehospital Index for Trauma

369

(2)

Prognosis after Major Trauma

371

(2)

Postoperative Infection and Peritonitis

373

(6)

Bacterial Infection after Abdominal Surgery

373

(2)

Peritonitis

375

(2)

Deciding to Reoperate: Abdominal Reoperation Predictive Index

377

(2)

Appendix A. Using Rule Retriever Software

379

(8)

Important Note

379

(1)

Installing Rule Retriever for Windows 95/98/NT

379

(1)

Running Rule Retriever for Windows 95/98/NT

379

(8)

Appendix B. InfoRetriever Demo

387

(2)

Index

389

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Evidence-Based Diagnosis: A Handbook of Clinical Prediction Rules (With CD-ROM)

Summary

Author Biography

Table of Contents

Supplemental Materials

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Evidence-Based Diagnosis: A Handbook of Clinical Prediction Rules (With CD-ROM)

Summary

Author Biography

Table of Contents

Supplemental Materials

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