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Journal Club - 2006-12-19

Diagnosis

Background:

1. Googling for a diagnosis--use of Google as a diagnostic aid: internet based study.

Tang H, Ng JH.
BMJ 2006;333:1143-5. PMID: 17098763
Journal Article.
PubMed:
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Google searches revealed the correct diagnosis in 15 (58%) cases.

Reply: PubMed versus Google – a brief comparison - PubMed did better

2. The MEDLINE search as a diagnostic maneuver.

Packer CD.
Arch Intern Med 2005;165:703-4. PMID: 15795353
Case Reports.
PubMed:
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A report of using Medline for a diagnosis

3. . . . And a diagnostic test was performed.

Greenwald R.
N Engl J Med 2005;353:2089-90. PMID: 16282191
Letter.
PubMed:
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The first report of Googling a diagnosis

4. Performance of four computer-based diagnostic systems.

Berner ES, Webster GD, Shugerman AA, Jackson JR, Algina J, Baker AL, Ball EV, Cobbs CG, Dennis VW, Frenkel EP.
N Engl J Med 1994;330:1792-6. PMID: 8190157
Case Reports.
PubMed:
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EBSCO - OVID

5. A computer-assisted medical diagnostic consultation service. Implementation and prospective evaluation of a prototype.

Bankowitz RA, McNeil MA, Challinor SM, Parker RC, Kapoor WN, Miller RA.
Ann Intern Med 1989;110:824-32. PMID: 2653156
Journal Article.
PubMed:
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Tools

Google. Google Scholar, PubMed, DxPlain

Available at http://clinical.uthscsa.edu

Cases:

Our case:

bump on back after after weight lifting, exam shows subq air on back

Case 1:

71 yo woman with 50-year history of Crohn's disease and a CNS mass with neuro findings

After doing your best with Google, try PubMed: crohn's disease AND Central nervous system tumors

Case 2:

42 year old woman with chronic microscopic hematuria, mild proteinuria, mild hypertension, normal creatinine, and a FMH of renal disease.

After doing your best with Google, try DxPlain

Additional cases

Case 3:

35 yo man with diarrhea, right-lower-quadrant pain...Grew up in Central America...endoscopy finds ileocecal inflammation and stricture with biospy showing with mononuclear cell inflammation and no granulomas...poor response to treatment for Crohn's

Case 4:

A 75 yo woman with nausea, hypotension and respiratory failure