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VII. How to Use a Clinical Decision Analysis A. Are the Results of the Study Valid?

W. Scott Richardson, MD; Allan S. Detsky, MD, PhD; the Evidence-Based Medicine Working Group

JAMA. 1995;273(16):1292-1295.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CLINICAL SCENARIO

You are the attending physician on an inpatient service where a 51-year-old man is admitted with congestive heart failure of recent onset. You find he has a dilated cardiomyopathy, the cause of which remains unknown after a thorough evaluation. He is in sinus rhythm. The team's resident asks you whether the patient should be anticoagulated with warfarin, enough to keep his international normalized ratio from 2.0 to 3.0, in order to prevent systemic emboli, even though his echocardiogram does not show left ventricular thrombus. You are not sure about the evidence concerning this issue, so you admit your shared knowledge gap and resolve to search together for the relevant information.

THE SEARCH

In the hospital's library, the two of you search the MEDLINE system us . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Medicine, University of Rochester (NY) School of Medicine and Dentistry (Dr Richardson), and the Departments of Health Administration and Medicine, University of Toronto (Ontario), and the Division of General Internal Medicine and Clinical Epidemiology, The Toronto (Ontario) Hospital (Dr Detsky).

Footnotes
A complete list of members (with affiliations) of the Evidence-Based Medicine Working Group appears in the first article of this series (JAMA. 1993;270:2093-2095). The following members contributed to this article: Gordon Guyatt, MD, MSc (chair); Deborah Cook, MD, MSc; Hertzel Gerstein, MD, MSc; Robert Hayward, MD, MPH; Anne Holbrook, MD, PharmD, MSc; Roman Jaeschke, MD, MSc; Elizabeth Juniper, MCSP, MSc; Mitchell Levine, MD, MSc; David Naylor, MD, DPhil; Andrew Oxman, MD, MSc, FACPM; David Sackett, MD, MSc; Sean Tunis, MD, MSc; Stephen Walter, PhD; John Williams, Jr, MD, MHS; and Mark Wilson, MD, MPH.

Reprint requests to Room 2C12, McMaster University Health Sciences Centre, 1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5 (Gordon Guyatt, MD, MSc).

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