This is by listener request! Here we analyse what went wrong in the case of man who presented with sudden onset back pain.
Here’s a link to the NNT website we reference in the episode. A great resource for likelihood ratios as well as objective evidence-based reviews.
The Rational Clinical Exam publication and on-line series is also highly recommended.
Thanks for your episode on Aortic Dissection — quite timely since September 19 was Aortic Disease Awareness day. As a vascular surgeon I need to reinforce a few things from your discussion which was great: 1. It is a common misconception that radio-radial or radio-femoral delay, or asymmetric BP is able to be used to EXCLUDE aortic dissection. They can SUPPORT or CONFIRM a diagnosis of aortic dissection but not the other way around. 2. Hypertension appears in aortic dissection in two settings being: a) severe pre-existing hypertension is a risk factor for AD and b) Type B aortic dissection… Read more »
Thanks Jason for your thoughtful comments. How do YOU think clinical reasoning differs for surgeons and physicians?
As an Australian physician, I am enjoying your interchanges.
I wonder if you are including the peculiar distortion of thinking that our eyes contribute to.
I’m thinking of trying to say the written word, eg red, when it is written in blue.
The eyes have it.
So, in this case, the fact that the ED doctors could not see the previously documented neurodeficit is not arrogance but the Visual Trump Bias (my contribution to your excellent list).
Thanks for the feedback although we have an unwritten ban in this podcast on any use of the word “trump”
great discussion ,as a GP registrar I learned a lot