Advanced Assessment-Interpreting Findings and Formulating by Mary Jo Goolsby, Laurie Grubbs

By Mary Jo Goolsby, Laurie Grubbs

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10 The Art of Assessment and Clinical Decision-Making A SUGGESTED READINGS Center, R. M. (2001). Clinical Prediction Rules for Dummies. html on February 9, 2005. H. (2001). Evidence-Based Diagnosis: A Handbook of Clinical Prediction Rules. New York: Springer. , & Schwarz, A. (2002). Evidence base of clinical diagnosis: Clinical problem solving and diagnostic decision making: Selective review of the cognitive literature. BMJ, 324: 729–732. Gross, R. (2001). Decisions and Evidence in Medical Practice: Applying EvidenceBased Medicine to Clinical Decision Making.

6 The Art of Assessment and Clinical Decision-Making include textbooks, primary reports of research, and published meta-analyses. Another source of statistics and the one that has been most widely used and available for application to the reasoning process includes the recall or estimation based on a provider’s experience, although these are rarely accurate. Over the past decade, the availability of evidence on which to base clinical reasoning is improving and there is an increasing expectation that clinical reasoning be based on scientific evidence.

Usually asymptomatic. If the keratoses are subjected to frequent trauma, by location and exposure, patients may complain of itching, tenderness, or irritation at their site. Seborrheic keratoses start as flat, light tan lesions and then evolve to become raised and have keratotic surfaces, often with increased pigmentation. The mature lesion has a “stuckon” appearance and the keratotic cover can be scraped off. Although they can occur anywhere, the most common sites include the trunk, face, and arms.

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