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Clinical Reasoning Corner: Likelihood Ratios

The Clinical Problem Solvers

Objectives Define likelihood ratios and their utility in diagnostic reasoning Identify how likelihood ratios alter the probability of a diagnosis Apply likelihood ratios in clinical reasoning What are likelihood ratios and how do they work? There are multiple physical exam findings associated with ascites including: Bulging flanks (LR = 1.9)

Clinic 52
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Dysphagia Revisited: A Podcast with Raele Donetha Robison and Nicole Rogus-Pulia

GeriPal

And then when you look long-term care facilities, more between that like 35 to 50%, and then much higher estimates in hospitalized older adults. Eric: And why is it more common in hospitalized adults? Nicole: Yeah, I think definitely delirium, but there are also a lot of medical conditions that can be specific to hospitalizations.

IT 124
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Screening for Dementia: A Podcast with Anna Chodos, Joseph Gaugler and Soo Borson

GeriPal

But the thing that really motivates me is seeing, you know, and trying to manage later stage, you know, we can call them complications of people who haven’t had a diagnosis are now really in, you know, a world of complexity around other conditions, around managing life and managing practical things. Why would we want to?

Screening 119
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EMS Intervention to Reduce Falls: Carmen Quatman and Katie Quatman-Yates

GeriPal

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. Carmen: Thank you.

Community 115
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Palliative Rehab?!?: Ann Henshaw, Tamra Keeney, and Sarguni Singh

GeriPal

Physical therapy had walked with him that day and noted improvement compared to previous walks, suggesting that he should be discharged to a skilled nursing facility for rehabilitation on discharge. At the end of the day, I lamented that physical, occupational, and speech therapists aren’t more tightly integrated with palliative care teams.

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RCT of Palliative Care for Heart Failure and Lung Disease: David Bekelman and Lyndsay DeGroot

GeriPal

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

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Under Pressure: Hypertensive Emergencies in the Pediatric Emergency Department

PEMBlog

Recognizing Hypertensive Emergencies The end-organ dysfunction component of this diagnosis presents as particular symptoms, physical exam findings, or laboratory and imaging results. Additionally, hydralazine is another agent that was previously utilized in pediatric hypertensive emergencies.