Tips for Teachers of Evidence-based Medicine: Clinical Prediction Rules (CPRs) and Estimating Pretest Probability

Thomas McGinn; Ramiro Jervis; Juan Wisnivesky; Sheri Keitz; Peter C. Wyer; Evidence-Based Medicine Teaching Tips Working Group

doi:10.1007/s11606-008-0623-z

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Tips for Teachers of Evidence-based Medicine: Clinical Prediction Rules (CPRs) and Estimating Pretest Probability

Journal article

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Peer reviewed

Tips for Teachers of Evidence-based Medicine: Clinical Prediction Rules (CPRs) and Estimating Pretest Probability

Thomas McGinn, Ramiro Jervis, Juan Wisnivesky, Sheri Keitz, Peter C. Wyer and Evidence-Based Medicine Teaching Tips Working Group

Journal of general internal medicine : JGIM, Vol.23(8), pp.1261-1268

05/20/2008

DOI: 10.1007/s11606-008-0623-z

PMCID: PMC2517969

PMID: 18491194

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Abstract

Background Clinical prediction rules (CPR) are tools that clinicians can use to predict the most likely diagnosis, prognosis, or response to treatment in a patient based on individual characteristics. CPRs attempt to standardize, simplify, and increase the accuracy of clinicians’ diagnostic and prognostic assessments. The teaching tips series is designed to give teachers advice and materials they can use to attain specific educational objectives. Educational Objectives In this article, we present 3 teaching tips aimed at helping clinical learners use clinical prediction rules and to more accurately assess pretest probability in every day practice. The first tip is designed to demonstrate variability in physician estimation of pretest probability. The second tip demonstrates how the estimate of pretest probability influences the interpretation of diagnostic tests and patient management. The third tip exposes learners to various examples and different types of Clinical Prediction Rules (CPR) and how to apply them in practice. Pilot Testing We field tested all 3 tips with 16 learners, a mix of interns and senior residents. Teacher preparatory time was approximately 2 hours. The field test utilized a board and a data projector; 3 handouts were prepared. The tips were felt to be clear and the educational objectives reached. Potential teaching pitfalls were identified. Conclusion Teaching with these tips will help physicians appreciate the importance of applying evidence to their every day decisions. In 2 or 3 short teaching sessions, clinicians can also become familiar with the use of CPRs in applying evidence consistently in everyday practice.

clinical learners

clinical prediction rules

evidence-based medicine

Teaching Tip

tips

Details

Title: Subtitle: Tips for Teachers of Evidence-based Medicine: Clinical Prediction Rules (CPRs) and Estimating Pretest Probability
Creators: Thomas McGinn - Icahn School of Medicine at Mount Sinai
Ramiro Jervis - Icahn School of Medicine at Mount Sinai
Juan Wisnivesky - Icahn School of Medicine at Mount Sinai
Sheri Keitz - University of Miami
Peter C. Wyer - Columbia University
Evidence-Based Medicine Teaching Tips Working Group
Contributors: Mark C Wilson (Contributor) - University of Iowa, Internal Medicine
Resource Type: Journal article
Publication Details: Journal of general internal medicine : JGIM, Vol.23(8), pp.1261-1268
DOI: 10.1007/s11606-008-0623-z
PMID: 18491194
PMCID: PMC2517969
NLM abbreviation: J Gen Intern Med
ISSN: 0884-8734
eISSN: 1525-1497
Publisher: Springer-Verlag
Language: English
Date published: 05/20/2008
Academic Unit: General Internal Medicine; Medicine Administration; Internal Medicine
Record Identifier: 9984359771902771

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