Preface to the Second Edition
In preparing the second edition, I have been mindful of the increasing interest in evidence-based medicine. The major update, therefore, has been to add tables of evidence-based test characteristics (sensitivity, specificity, likelihood ratio) for selected items in the history and physical examination. This book contains the most comprehensive compilation of EBM physical diagnosis data available to date. I have utilized state-of-the-art data sources such as the JAMA Rational Clinical Examination series; Straus, Hsu, Ball, and Phillips' Evidence-Based Acute Medicine; and McGee's Evidence-Based Physical Diagnosis, in addition to my own extensive literature files. Diagnostic hypotheses arising from these observations form the basis for accurate application and interpretation of diagnostic technology. Testing and treatment—as well as citations of literature sources—remain beyond the scope of this book.
While I have retained the user-friendly format of the first edition, a second area of substantial enhancement and revision has been the diagnostic approach section of most chapters, to strengthen the high-altitude view of how to begin to approach the differential. Finally, the diagnostic images section has been completely revised. Images have been selected to best illustrate clinical phenomenon, and to favor visible manifestations of systemic diseases and more serious diagnoses over self-limited dermatologic conditions. Of the 192 images in this book, 84 are new to this edition. They have been arranged by organ system and by diagnoses to parallel the text and to make locating images more intuitive.
The aim of this book remains to be compact, colorful, aesthetic, and useful.
New Haven, January 2006
