RT Book, Section
A1 Mark, Daniel B.
A1 Wong, John B.
A2 Jameson, J. Larry
A2 Fauci, Anthony S.
A2 Kasper, Dennis L.
A2 Hauser, Stephen L.
A2 Longo, Dan L.
A2 Loscalzo, Joseph
SR Print(0)
ID 1155940793
T1 Decision-Making in Clinical Medicine
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accesspharmacy.mhmedical.com/content.aspx?aid=1155940793
RD 2024/04/19
AB Sir  William  Osler’s  familiar  quote  “Medicine  is  a  science  of  uncertainty  and  an  art  of  probability”  captures  well  the  complex  nature  of  clinical  medicine.  Although  the  science  of  medicine  is  often  taught  as  if  the  mechanisms  of  the  human  body  operate  with  Newtonian  predictability,  every  aspect  of  medical  practice  is  infused  with  an  element  of  irreducible  uncertainty  that  the  clinician  ignores  at  her  peril.  Clinical  medicine  has  deep  roots  in  science,  but  it  is  an  imprecise  science.  More  than  100  years  after  the  practice  of  medicine  took  its  modern  form,  it  remains  at  its  core  a  craft,  to  which  individual  doctors  bring  varying  levels  of  skill  and  understanding.  With  the  exponential  growth  in  medical  literature  and  other  technical  information  and  an  ever  increasing  number  of  testing  and  treatment  options,  twenty-first  century  physicians  who  seek  excellence  in  their  craft  must  master  a  more  diverse  and  complex  set  of  skills  than  any  of  the  generations  that  preceded  them.  This  chapter  provides  an  introduction  to  three  of  the  pillars  upon  which  the  craft  of  modern  medicine  rests:  (1)  expertise  in  clinical  reasoning  (what  it  is  and  how  it  can  be  developed);  (2)  rational  diagnostic  tests,  use  and  interpretation;  and  (3)  integration  of  the  best  available  research  evidence  with  clinical  judgment  in  the  care  of  individual  patients  (evidence-based  medicine  or  EBM  and  the  tools  of  EBM).