The Best Special Test – Scientific Reasoning in the Clinical Exam (Part 3)

Congratulations! If you’ve made it to this point, you’re one last step closer to becoming a better clinician, more adept at logical and critical thinking — and probably a better person overall;)

Today, we will discuss the best special test out there. This one test can

Single Blind Study – Scientific Reasoning in the Clinical Exam (Part 2)

http://laughingsquid.com/maximum-strength-placebo/

So we all know that our patients experience pain relief from many placebo based mechanisms. A little bit of joint cracking, needle tapping, and (insert modality here) can go a long way towards providing a patient some temporary relief which gets us to our main goal of restoring movement.

There has been decades of research on the aspects of placebo:

• 2 sugar pills better than 1 for reducing gastric ulcers(1)
• 1 injection better than 2 sugar pills for reducing gastric ulcers(1)
• Higher priced items are more effective than cheaper ones, but only when people know they are the higher priced meds.(1)

Just more fun facts…

On a scale of 0 to 10…

Img Cred

Every answer, thought, feeling, decision stems from a reference-point. A single value cannot bring meaning to an informed decision.  Ex: A 60 degree winter day is warm to those in Boston, and cool to those in San Diego.  An increase of strength by 5 lbs is a lot with shoulder external rotation, but not so much with a leg press…. or maybe it is a lot for the leg press in someone recovering from Guillain-Barré. Transporting in a wheel chair does not seem so good, unless you have been bed bound for the previous year.  So the reference is an imperative portion

Are you biased, bro? – Scientific Reasoning in the Clinical Exam (Part I)

img cred

Short answer is: yes, more than you know.

Bias is so prevalent, it’s almost