Clinicopathological conferences: The fading art of playing Sherlock Holmes

• Published in: Neurology India 2017-05, Vol.65 (3), p.685-688
• Main Authors: Vilanilam, George C, Mahadevan, Anita, John, Praveen Kumar, Das, Joe M
• Format: Article
• Language: English
• Subjects: Clinical medicine; Cognition & reasoning; Guillain-Barre syndrome; Hospitals; Medicine; Neurology; Neuropathology; Neurosurgery; Problem based learning
• ISSN: 0028-3886; 1998-4022
• DOI: 10.4103/neuroindia.NI_83_17

The dying art of an unbiased analysis of evidence in clinical practice, amidst a din of sophisticated investigations, is a worrying phenomenon. [...]we aimed to evaluate, The current status of CPCs across some institutes in India andThe existing limitations and cynical viewsabout the practice of CPCs. [2],[3] While most scientific lessons in medicine are learned from pattern recognition in large case series, legal sciences assign significant importance to singular landmark cases and judgments. [2],[5] Since 1924, CPCs have been published regularly in the New England Journal of Medicine as Case Records of the Massachusetts General Hospital. [...]the origin of CPCs lies in the concept of encouraging case-based learning wherein factual knowledge finds practical application. The key elements in a traditionally styled CPC include,[4],[5],[6] The presenter - the treating doctor or resident who presents the history, examination, and investigations in a factual andunbiased mannerThe discussant - analyzes the information provided in a logical, deductive sequence and arrives at a detailed differential diagnosis, finally pinning it down to the most probable diagnosisThe other experts - aid to interpret specialized investigations such as histology, genetic markers, radiological imaging, nuclear medicine scans, etcThe audience - who enlighten CPCs with animated questioning and thought provoking debates. Each medical specialist often views an illness through the window of his or her own specialty. [...]upper abdominal pain could appear to be an acute coronary event to a cardiologist, reflux esophagitis to the gastroenterologist, acute hepatitis to the internist, cholecystitis to the general surgeon, endometriosis to the gynaecologist,...