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Home > CME > Courses
Evidence-Based Medicine:
Effective Diagnostic Testing - Part 1

Certified for 1 Category 1 AMA Credit.

Presented by the University of Alabama School of Medicine
Division of Continuing Medical Education

Release Date: April 28, 2009
Expiration Date: April 28, 2012

Target Audience
Objectives
Source
CME Participation
Accreditation & Credit

Introduction
Case 1
Case Question #1
References

TARGET AUDIENCE:
Primary care physicians

OBJECTIVES:
Upon completion of this CME activity, participants should be able to:
  • Describe how to thoughtfully use diagnostic tests in caring for patients.
  • Describe how to use sensitivity, specificity, and likelihood ratios to choose among diagnostic tests.
  • Understand the influence of pre-test probability on clinical decision making.
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SOURCE:
FACULTY:

Terrence Shaneyfelt, MD
Associate Professor, Department of Medicine
Division of General Internal Medicine
University of Alabama at Birmingham
Birmingham, Alabama
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DISCLOSURE:
The faculty has no commercial affiliations to disclose.

Because of the nature of preliminary studies, some products mentioned are unlabeled and investigational. Dosages, indications, and methods of use of drugs mentioned in this publication may reflect the experience of the authors, clinical literature, or other resources. Therefore, please see the full prescribing information before using any licensed product mentioned.

CME PARTICIPATION:
To participate in this online course for CME credit, please review the objectives before beginning the program. Complete the course and the self-assessment test before April 28, 2012 to receive CME credit. Your certificate will then be available online. This process should take approximately 1 hour.
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ACCREDITATION:

The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The University of Alabama School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The boards of nursing in many states, including Alabama, recognize Category 1 continuing medical education courses as acceptable activities for the renewal of license to practice nursing.
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DISCLAIMER:
Dosages, indications, and methods of use of any drug referred to in this publication may reflect the clinical experience of the authors, clinical literature, or other clinical resources. Therefore, please see the full prescribing information before using any product mentioned. UAB is an equal opportunity/affirmative action institution.
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INTRODUCTION:

This online course will be the first of two covering basic principles of evidence based medicine (EBM) principles applied to diagnostic testing. Unlike past online courses, this one will not focus on a single disease but will present several disease scenarios to demonstrate EBM diagnostic principles.

The principles demonstrated here can be applied to all diagnostic situations but are especially important in “high stakes” decision making (i.e., ones in which the patient can have adverse outcomes if the wrong diagnosis or decision is made).

This material may not be quickly translated into practice by clinicians who are unfamiliar with the topic. It usually takes more than one time through to be able to apply it to daily practice.

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Case 1 of 3:

A 62-year-old male complains of substernal chest pain that he describes as a dull ache lasting 5-10 minutes. The pain occurs at rest, but is relieved with SL NTG. The pain radiates to his left shoulder, but he has no other associated symptoms. He has had “several” episodes over the past 1-2 months, but they seem to be getting more frequent over the last few weeks.
He is a nonsmoker.
Family history is negative
PMH: hypertension
Meds: HCTZ, NTG prn, lisinopril, aspirin
ECG: NSR without ischemic changes.
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Case 1, Questions to Consider:

The following questions are for your consideration only. No answer is required. Discussion of these questions will occur following the third case.

  1. Based on your clinical experience, what is your estimate of this patient's chance of having significant coronary artery disease (CAD)?
  2. Which one of the following would describe the patient's chance of having significant CAD?

    A. Low chance
    B. Intermediate chance
    C. High chance
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Continue to Case 2 . . .

 
 
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