| Foreword | p. vii |
| Preface to the Second Edition | p. ix |
| Acknowledgments | p. xiii |
| A Note About the Book's Format | p. xiv |
| The Processes of Clinical Reasoning | |
| Overview | p. 3 |
| Introduction | p. 3 |
| Diagnosis is an Inferential Process | p. 5 |
| Problem-Solving Strategies | p. 5 |
| Diagnosis Based on Hypothesis Generation and Testing | p. 5 |
| Alternate Concepts of Diagnostic Strategies | p. 6 |
| Therapeutic Principles | p. 6 |
| Linking Diagnosis and Treatment | p. 7 |
| Diagnostic Hypothesis Generation | p. 8 |
| Hypotheses and Cues | p. 8 |
| The Cognitive Basis of Hypothesis Generation | p. 8 |
| Hypotheses as a Context | p. 9 |
| Expertise and Error | p. 9 |
| Refinement of Diagnostic Hypotheses | p. 11 |
| Where Refinement Begins and Ends | p. 11 |
| Context and Diagnostic Classification | p. 11 |
| Hypothesis Evolution | p. 12 |
| Sequence of Data Collection | p. 12 |
| Reducing Diagnostic Uncertainty | p. 13 |
| The Differential Diagnosis | p. 14 |
| Relation to Formal Probabilistic Approach | p. 14 |
| Use and Interpretation of Diagnostic Tests | p. 15 |
| The Function of Tests | p. 15 |
| Quantifying Testing Decisions | p. 15 |
| Sensitivity and Specificity | p. 16 |
| Bayes' Rule | p. 17 |
| Testing Principles | p. 18 |
| Bayesian Revision for Multiple Results | p. 19 |
| Bayesian Revision for Multiple Diseases With Multiple Attributes | p. 21 |
| Pragmatic Considerations in the Probabilistic Approach | p. 22 |
| Interpreting Results | p. 23 |
| When to Test | p. 23 |
| The Threshold Concept | p. 24 |
| The Therapeutic Threshold | p. 24 |
| Testing Thresholds | p. 25 |
| Causal Reasoning | p. 28 |
| Definition | p. 28 |
| Using a Causal Model | p. 29 |
| Where in the Diagnostic Process Does Causal Reasoning Fit? | p. 29 |
| Explaining Relations Between Variables | p. 30 |
| Diagnostic Verification | p. 31 |
| Definition | p. 31 |
| Criteria of Validity | p. 31 |
| Premature Closure | p. 31 |
| The Penultimate Result: A Working Diagnosis | p. 32 |
| Therapeutic Decision Making | p. 33 |
| Principles | p. 33 |
| Treatment Under Conditions of Uncertainty | p. 33 |
| When the Value of Therapeutic Choices is Close | p. 34 |
| Incommensurate Options | p. 34 |
| Quantitative Therapeutic Decision Making | p. 34 |
| Examining Evidence | p. 36 |
| Introduction | p. 36 |
| Evidence-Based Medicine | p. 36 |
| Asking Questions | p. 36 |
| Searching for Evidence | p. 37 |
| Summarizing and Appraising Evidence | p. 37 |
| Applying the Evidence | p. 37 |
| Practice Guidelines | p. 38 |
| Cognitive Errors | p. 39 |
| Scope | p. 39 |
| Classification | p. 39 |
| Some Errors may have a Psychological Origin | p. 39 |
| The Nature of Cognitive Errors | p. 39 |
| Cognitive Biases in the Laboratory | p. 40 |
| Consequences of Cognitive Biases | p. 40 |
| Strategies for Avoiding Cognitive Errors | p. 41 |
| Some Cognitive Concepts | p. 42 |
| Cognitive Science | p. 42 |
| Studying Mental Processes | p. 42 |
| The Structure of Memory | p. 42 |
| Search Strategies | p. 44 |
| Characteristics of Expertise | p. 46 |
| Learning Clinical Problem Solving | p. 48 |
| Facts Versus Process | p. 48 |
| Pedagogic Principles | p. 49 |
| A Specific Example | p. 49 |
| The Goal Should Determine the Format | p. 50 |
| Learning by Instantiation | p. 50 |
| Learning Clinical Problem Solving Versus Problem-Based Learning | p. 51 |
| Cognition at the Bedside: A Set of Examples | |
| Introduction to the Cases | p. 55 |
| Diagnostic Hypothesis Generation | p. 56 |
| Generation of Diagnostic Hypotheses | p. 56 |
| Hypothesis Triggering by an Expert | p. 60 |
| A Diagnostic Coup | p. 63 |
| A Quick and Accurate Solution | p. 66 |
| Better Late Than Never | p. 69 |
| A Hit After a Miss | p. 73 |
| The Critical Role of Context in the Diagnostic Process | p. 76 |
| A Masked Marauder | p. 81 |
| A Serious Lack of Focus | p. 84 |
| Refinement of Diagnostic Hypotheses | p. 89 |
| What is a Differential Diagnosis? | p. 89 |
| An Orderly, Sequential Approach | p. 94 |
| Weak Reasoning: Diagnosis by Drug Reaction | p. 96 |
| Narrowing Down the Diagnostic Options | p. 100 |
| A Picture is Worth a Thousand Words | p. 104 |
| Strategies of Information Gathering | p. 108 |
| A Fatal Flaw in Sutton's Law | p. 113 |
| How to Disregard Red Herrings | p. 118 |
| Discrimination: The Problem of Look-Alikes | p. 121 |
| Location, Location, Location | p. 125 |
| Use and Interpretation of Diagnostic Tests | p. 128 |
| Interpreting a Negative Test Result | p. 128 |
| Diagnosis and the Risks of the Primrose Path | p. 131 |
| Searching for a Pony | p. 134 |
| Interpreting Hoofbeats: Can Bayes Help Clear the Haze? | p. 137 |
| Short-Circuiting the Diagnostic Process | p. 143 |
| The Bypass on the Way to the Bypass | p. 145 |
| It is What You Believe That Counts | p. 148 |
| Renal Rescue by Reverend Bayes | p. 152 |
| A Diagnostic Fluke | p. 155 |
| Surprise! | p. 157 |
| Tripping Over Technology | p. 161 |
| The Probability of a Probability | p. 165 |
| Causal Reasoning | p. 169 |
| Judging Causality | p. 169 |
| Post Hoc, Ergo Propter Hoc | p. 171 |
| The Case for Causal Reasoning | p. 175 |
| The Tricky Task of Attributing Causation | p. 180 |
| The Right Answer for the Wrong Reason | p. 183 |
| Diagnostic Verification | p. 186 |
| A Point-By-Point Dissection of Clinical Reasoning | p. 186 |
| Leaving No Stone Unturned | p. 188 |
| Verification | p. 192 |
| A Meticulous Approach | p. 196 |
| A Diagnostic Quandary | p. 199 |
| Diagnosis by Fiat | p. 203 |
| Iron Pyrite and Diagnostic Confirmation | p. 207 |
| Therapeutic Decision Making | p. 209 |
| The Surgeon Opts to Operate: Why? | p. 209 |
| Treat or Keep Testing? | p. 211 |
| Watch and Wait, or Operate? | p. 216 |
| An Apple or an Orange? | p. 218 |
| Examining Evidence | p. 223 |
| A Difficult Tradeoff | p. 223 |
| Making Judgments When the Evidence is Not Definitive | p. 225 |
| Using and Citing Published Evidence | p. 227 |
| A Little Math Makes the Medicine Go Down | p. 229 |
| A Rewarding Pursuit of Certainty | p. 234 |
| Treating Before Knowing | p. 239 |
| Cognitive Errors | p. 244 |
| A Defective Detective | p. 244 |
| Remedies for Faulty Hypothesis Generation | p. 248 |
| A Disaster Averted | p. 252 |
| Derailed by the Availability Heuristic | p. 255 |
| Wrong Diagnosis, Wrong Tests, Wrong Treatment | p. 262 |
| Reconsidering Failures of Therapy | p. 266 |
| The Cheetah and the Snail | p. 267 |
| A Collection of Cognitive Diagnostic Errors | p. 271 |
| Some Cognitive Concepts | p. 275 |
| A Message about Methods | p. 275 |
| Memory: How We Overcome its Limitations | p. 279 |
| Diagnosis and the Structure of Memory; Disease Polymorphism and Mental Models | p. 281 |
| Intuitive and Inspirational, or Inductive and Incremental? | p. 286 |
| Knowledge and Clinical Expertise | p. 291 |
| Learning Clinical Problem Solving | p. 295 |
| Learning Clinical Reasoning from Examples | p. 295 |
| Making a Silk Purse out of a Sow's Ear | p. 299 |
| Optimizing Case Discussions | p. 304 |
| Glossary | p. 308 |
| Bibliography | p. 313 |
| Index | p. 325 |
| Table of Contents provided by Ingram. All Rights Reserved. |
