Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group

TLDR

A clinician in the library seeks guidance on interpreting V/Q lung scans for a 28‑year‑old man who presents with acute shortness of breath and chest pain after a 10‑hour car trip, having had prior mild episodes but now feeling apprehensive. The clinician applies Table 1 criteria to select the PIOPED study as the evidence source, and after a normal physical exam, ECG, chest radiograph, and blood gas measurements, proceeds with the analysis.

Abstract

<h3>CLINICAL SCENARIO</h3> You are back where we put you in the previous article¹on diagnostic tests in this series on how to use the medical literature: in the library studying an article that will guide you in interpreting ventilation-perfusion (V/Q) lung scans. Using the criteria in Table 1, you have decided that the Prospective Investigation of Pulmonary Diagnosis (PIOPED) study²will provide you with valid information. Just then, another physician comes looking for an article to help with the interpretation of V/Q scanning. Her patient is a 28-year-old man whose acute onset of shortness of breath and vague chest pain began shortly after completing a 10-hour auto trip. He experienced several episodes of similar discomfort in the past, but none this severe, and is very apprehensive about his symptoms. After a normal physical examination, electrocardiogram and chest radiograph, and blood gas measurements that show a Pco₂of