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, Deborah Cook, Gordon Guyatt, Ted Haines, Roman Jaeschke, Rose Hatala, Robert Hayward, Bruce Fisher, Alexandra Barratt, Antonio L. Dans, Cassie Kennedy, Victor M. Montori, Jennifer Kleinbart, Anna Lee, Anthony Ho, Gavin M. JoyntRosanne Leipzig, Thomas McGinn, Virginia Moyer, Thomas B. Newman, Kameshwar Prasad, Scott Richardson, Mark C. Wilson

Research output: Contribution to journalReview article

18 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1261-1268
Number of pages8
JournalJournal of General Internal Medicine
Volume23
Issue number8
DOIs
StatePublished - Aug 2008

Keywords

  • Clinical learners
  • Clinical prediction rules
  • Evidence-based medicine
  • Tips

ASJC Scopus subject areas

  • Internal Medicine

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    McGinn, T., Jervis, R., Wisnivesky, J., Keitz, S., Wyer, P. C., Cook, D., Guyatt, G., Haines, T., Jaeschke, R., Hatala, R., Hayward, R., Fisher, B., Barratt, A., Dans, A. L., Kennedy, C., Montori, V. M., Kleinbart, J., Lee, A., Ho, A., ... Wilson, M. C. (2008). Tips for teachers of evidence-based medicine: Clinical prediction rules (CPRs) and estimating pretest probability. Journal of General Internal Medicine, 23(8), 1261-1268. https://doi.org/10.1007/s11606-008-0623-z