Practice solving diagnostic puzzles at Kashlak Morning Report with Internist / Diagnostician, Reza Manesh MD, Assistant Program Director for Clinical Reasoning of the Osler Medical Training Program at Johns Hopkins! Solve along with us at these links: Case 1 and Case 2. Topics include: clinical reasoning terminology, how to use cases to practice diagnostic reasoning, how to build a diagnostic schema, and how to conduct your own cognitive autopsy.
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Written and Produced by: Hannah Abrams
Hosts: Hannah Abrams, Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
Guest: Reza Manesh MD
Special thanks to: Doctors Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing cases
“Human Dx” or “the Project” is a worldwide effort created with and led by the global medical community to build an open intelligence system that maps the steps to helping any patient. Their idea is that by combining the collective intelligence of doctors with machine learning, they can enable more accurate, affordable, and accessible care for all.
Human Dx chooses three cases per day (Adult Medicine, Pediatrics, Primary Care) to serve as Global Morning Report. The cases are reviewed by at least two editors, teaching points are added, and they are distributed via email to registered users and via the Human Dx app. Listeners can get CME credit for solving the cases!
Like in a real patient case, a limited amount of information is provided from which you create your working differential diagnosis. As you get more history, exam findings, or tests, you can update that differential until you get enough information to reach the actual diagnosis. After, you can see how others solved the case and how you did on:
You can submit cases to email@example.com and the GMR editors will review the submissions. If published, you can cite it on your CV as an open access publication.
On this episode, we’ll present 2 cases: one for Reza to solve and the other for the Curbsiders team. They’ll attempt to solve it in real-time without any prior knowledge of its content, and with each new diagnostic finding we’ll figure out what our differential diagnosis is and what we think is most likely going on. At the end of each case we’ll reveal the diagnosis, talk through a few teaching points, and do a “cognitive autopsy” of our own diagnostic reasoning process. To play along, follow these links: Case 1 and Case 2.
Check out https://clinicalreasoning.org
Highlighting the defining features of a case, including epidemiology, duration of symptoms, and clinical syndrome. “This is what you enter into the Google Chrome search engine.”
Your mental ‘file’ for a disease process, including pathophysiology, clinical syndrome, diagnosis, treatment, and epidemiology.
Reflecting on your own diagnostic thought process and seeing if you could have performed better or not; assessing your mistakes to see if you could have performed differently if presented the same clinical scenario again.
Coming up with a hypothesis, and then testing it and either accepting, rejecting, or modifying it. This is what Human Dx prompts you to do!
A systematic way to tackle a clinical problem by having an organized approach.
About Case 1: Written by Dr. Zaven Sargsyan and edited by Dr. Stephanie Sherman, the case of a “44-year-old woman with recurrent episodes of dizziness and palpitations.”
Diagnostic schemas are a helpful tool to build for a given syndrome or symptom. They can also serve as ‘checklists’ for diagnostic workups to make sure you don’t miss anything!
About Case 2: Written by Dr. John Hwang, the case of a “63 year old male presenting to the clinic with jaundice.”
Listeners will learn to use case-based exercises to ‘train their brain’ and improve their diagnostic reasoning.
After listening to this episode listeners will…
Dr. Manesh recieves an honorarium from The Human Diagnosis Project for his role as supervising editor of the adult medicine section of Global Morning Report. The Curbsiders are an educational partner of The Human Diagnosis Project for this episode.
Manesh, Reza. Guest expert. “#126: Kashlak Morning Report with Human Dx.” The Curbsiders Internal Medicine Podcast http://thecurbsiders.com. November 19, 2018. http://thecurbsiders.libsyn.com/126-kashlak-morning-report-with-human-dx-0
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.
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Just finished #28, Superb discussion!
Great episode! More of this please and do consider Jeff Weiss as a guest! :D
I really enjoy the curbsiders podcast in general but this was a particularly awesome episode! Loved it!! I learnt so much and it was wonderful to be able to hear you guys talk through your reasoning. Hearing people thinking about thinking can be pretty dull but this was entertaining & informative (and not dull in the least).