The Patient History: Evidence-Based Approach


Book Description

The definitive evidence-based introduction to patient history-taking NOW IN FULL COLOR For medical students and other health professions students, an accurate differential diagnosis starts with The Patient History. The ideal companion to major textbooks on the physical examination, this trusted guide is widely acclaimed for its skill-building, and evidence based approach to the medical history. Now in full color, The Patient History defines best practices for the patient interview, explaining how to effectively elicit information from the patient in order to generate an accurate differential diagnosis. The second edition features all-new chapters, case scenarios, and a wealth of diagnostic algorithms. Introductory chapters articulate the fundamental principles of medical interviewing. The book employs a rigorous evidenced-based approach, reviewing and highlighting relevant citations from the literature throughout each chapter. Features NEW! Case scenarios introduce each chapter and place history-taking principles in clinical context NEW! Self-assessment multiple choice Q&A conclude each chapter—an ideal review for students seeking to assess their retention of chapter material NEW! Full-color presentation Essential chapter on red eye, pruritus, and hair loss Symptom-based chapters covering 59 common symptoms and clinical presentations Diagnostic approach section after each chapter featuring color algorithms and several multiple-choice questions Hundreds of practical, high-yield questions to guide the history, ranging from basic queries to those appropriate for more experienced clinicians




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




Oxford Handbook of Clinical Diagnosis


Book Description

This handbook describes the diagnostic process clearly and logically, aiding medical students and others who wish to improve their diagnostic performance and to learn more about the diagnostic process.




Diagnosing Literary Genius


Book Description

Winner of the Aldo and Jeanne Scaglione Prize for Studies in Slavic Languages and Literatures from the Modern Language Association The vital place of literature and the figure of the writer in Russian society and history have been extensively studied, but their role in the evolution of psychiatry is less well known. In Diagnosing Literary Genius: A Cultural History of Psychiatry in Russia, 1880-1930, Irina Sirotkina explores the transformations of Russian psychiatric practice through its relationship to literature. During this period, psychiatrists began to view literature as both an indicator of the nation's mental health and an integral part of its well-being. By aligning themselves with writers, psychiatrists argued that the aim of their science was not dissimilar to the literary project of exploring the human soul and reflecting on the psychological ailments of the age. Through the writing of pathographies (medical biographies), psychiatrists strengthened their social standing, debated political issues under the guise of literary criticism, and asserted moral as well as professional claims. By examining the psychiatric engagement with the works of Fyodor Dostoevsky, Nikolai Gogol, Leo Tolstoy, and the decadents and revolutionaries, Sirotkina provides a rich account of Russia's medical and literary history during this turbulent revolutionary period.




The Role of Telehealth in an Evolving Health Care Environment


Book Description

In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.




Advances in Patient Safety


Book Description

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.




Weariness of the Self


Book Description

Depression, once a subfield of neurosis, has become the most diagnosed mental disorder in the world. Why and how has depression become such a topical illness and what does it tell us about changing ideas of the individual and society? Alain Ehrenberg investigates the history of depression and depressive symptoms across twentieth-century psychiatry, showing that identifying depression is far more difficult than a simple diagnostic distinction between normal and pathological sadness - the one constant in the history of depression is its changing definition. Drawing on the accumulated knowledge of a lifetime devoted to the study of the individual in modern democratic society, Ehrenberg shows that the phenomenon of modern depression is not a construction of the pharmaceutical industry but a pathology arising from inadequacy in a social context where success is attributed to, and expected of, the autonomous individual. In so doing, he provides both a novel and convincing description of the illness that clarifies the intertwining relationship between its diagnostic history and changes in social norms and values. The first book to offer both a global sociological view of contemporary depression and a detailed description of psychiatric reasoning and its transformation - from the invention of electroshock therapy to mass consumption of Prozac - The Weariness of the Self offers a compelling exploration of depression as social fact.




Psychopathology


Book Description

Edited and written by true leaders in the field, Psychopathology provides comprehensive coverage of adult psychopathology, including an overview of the topic in the context of the DSM. Individual chapters cover the history, theory, and assessment of Axis I and Axis II adult disorders such as panic disorder, social anxiety, bipolar disorders, schizophrenia, and borderline personality disorder.




The Medical Interview


Book Description

Primary care medicine is the new frontier in medicine. Every nation in the world has recognized the necessity to deliver personal and primary care to its people. This includes first-contact care, care based in a posi tive and caring personal relationship, care by a single healthcare pro vider for the majority of the patient's problems, coordination of all care by the patient's personal provider, advocacy for the patient by the pro vider, the provision of preventive care and psychosocial care, as well as care for episodes of acute and chronic illness. These facets of care work most effectively when they are embedded in a coherent integrated approach. The support for primary care derives from several significant trends. First, technologically based care costs have rocketed beyond reason or availability, occurring in the face of exploding populations and diminish ing real resources in many parts of the world, even in the wealthier nations. Simultaneously, the primary care disciplines-general internal medicine and pediatrics and family medicine-have matured significantly.




Medical Apartheid


Book Description

NATIONAL BOOK CRITICS CIRCLE AWARD WINNER • The first full history of Black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment. No one concerned with issues of public health and racial justice can afford not to read this masterful book. "[Washington] has unearthed a shocking amount of information and shaped it into a riveting, carefully documented book." —New York Times From the era of slavery to the present day, starting with the earliest encounters between Black Americans and Western medical researchers and the racist pseudoscience that resulted, Medical Apartheid details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how Blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of Blacks. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions. The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused Black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust.