■ Ask open-ended questions and listen carefully and patiently to the patient's story.
■ Craft a thorough and systematic sequence to history-taking and physical examination.
■ Keep an open mind toward both the patient and the data.
■ Always include "the worst-case scenario" in your list of possible explanations of the patient's problem, and make sure it can be safely eliminated.
■ Analyze any mistakes in data collection or interpretation.
■ Confer with colleagues and review the pertinent medical literature to clarify uncertainties.
■ Apply principles of data analysis to patient information and testing.
Symptoms, physical findings, tests, and x-rays should help you reduce uncertainty about whether a patient does or does not have a given condition. Clinical data, including laboratory work, however, are inherently imperfect. You can improve your assessment of clinical data and laboratory tests by applying several key principles for selecting and using clinical data and tests. Learn to apply the principles of reliability, validity, sensitivity, specificity, and predictive value to your clinical findings and the tests you order. These test characteristics will help you decide how confident you can be of your findings and test results as you assess the presence or absence of a disease or problem.
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