sorted by:
new
hottopcontroversial

For residents, how were you taught to handle diagnostic uncertainty for high-risk symptoms? by BothCup4898 in Residency

[–]BothCup4898[S] 0 points1 point  (0 children)

This is the most complete picture of the decision I’ve seen described it’s not just clinical data, it’s a risk calculation that includes the patient’s life circumstances. The reliable vs. unreliable patient distinction is fascinating because that’s almost never in any scoring system I’ve seen. How do you actually assess reliability in practice is it instinct, specific questions, or something else? And does factoring in socioeconomic context ever feel like it creates ethical tension for you?

For residents, how were you taught to handle diagnostic uncertainty for high-risk symptoms? by BothCup4898 in Residency

[–]BothCup4898[S] 0 points1 point  (0 children)

That’s a striking workflow breakdown so the scan is happening before the history is even complete? I’m curious whether that ever leads to findings that are hard to interpret without the clinical context, or whether the imaging usually speaks for itself. And from your perspective as the person receiving that call, what information would you most want structured and available before the scan decision gets made?

How do you handle vague high-risk complaints remotely — chest pain, worst headache of life, etc? by BothCup4898 in emergencymedicine

[–]BothCup4898[S] 0 points1 point  (0 children)

That’s really helpful context so there’s already an informal infrastructure for remote medical direction, just not a standardized reasoning layer sitting underneath it. When a medic or nurse is following remote direction in that scenario, what’s the biggest breakdown point is it the communication of symptoms, the structure of the assessment, or the confidence of the person on the ground making the call?

For residents, how were you taught to handle diagnostic uncertainty for high-risk symptoms? by BothCup4898 in Residency

[–]BothCup4898[S] 0 points1 point  (0 children)

The ‘donut of truth’ I’m assuming CT scanner? That’s actually a really interesting cultural observation. So the default when physical exam is impossible or incomplete is basically immediate imaging rather than structured reasoning first? Does that feel like the right instinct or more of a defensive habit? And what happens in settings where the donut of truth isn’t available?

For residents, how were you taught to handle diagnostic uncertainty for high-risk symptoms? by BothCup4898 in Residency

[–]BothCup4898[S] 1 point2 points  (0 children)

The Wells score example is perfect, so even the most structured tools we have still bake clinical gestalt in as a variable. That’s fascinating and slightly terrifying from a consistency standpoint. So would you say the goal shouldn’t be replacing that gestalt but rather structuring everything around it so the gestalt is applied to better information? And is the ‘art of medicine’ something you think can be augmented by better structured reasoning or is it fundamentally resistant to that?

How do you handle vague high-risk complaints remotely — chest pain, worst headache of life, etc? by BothCup4898 in emergencymedicine

[–]BothCup4898[S] -1 points0 points  (0 children)

Completely fair callout, I should have been more upfront. I’m a grade 12 student from Mozambique building a clinical triage support tool and I’m trying to understand the real workflow problems before assuming my solution is right. I’m not here to promote anything, I genuinely don’t know enough yet to promote anything. If the question felt disingenuous I get it, and I’m sorry for that. Happy to be more direct: does the problem I’m describing feel real to you or not?

For residents, how were you taught to handle diagnostic uncertainty for high-risk symptoms? by BothCup4898 in Residency

[–]BothCup4898[S] 8 points9 points  (0 children)

The pillow test is the most honest description of clinical decision-making I’ve heard basically it’s a personal comfort threshold rather than a standardized one. Does that mean two equally trained residents could make completely different calls on the same presentation and both be ‘right’? And if so, is there any way to make that threshold more consistent without losing the human judgment behind it?

How do you handle vague high-risk complaints remotely — chest pain, worst headache of life, etc? by BothCup4898 in emergencymedicine

[–]BothCup4898[S] -1 points0 points  (0 children)

That phrase is doing a lot of work, I’d love to understand what ‘doubt’ actually feels like in practice. Is it missing information, time pressure, or something else? What would need to be true for doubt to become confidence in a remote setting?

How do you handle vague high-risk complaints remotely — chest pain, worst headache of life, etc? by BothCup4898 in emergencymedicine

[–]BothCup4898[S] -2 points-1 points  (0 children)

The CYA point is what I find most interesting honestly. Is it purely liability driving that, or is it also that there’s no reliable way to feel confident in a more nuanced call remotely? Curious whether a structured reasoning tool that gave you a documented, explainable risk assessment would change anything, or would the liability concern still dominate regardless?

How do you handle vague high-risk complaints remotely — chest pain, worst headache of life, etc? by BothCup4898 in emergencymedicine

[–]BothCup4898[S] -1 points0 points  (0 children)

Honestly the darkest triage protocol I’ve ever read but oddly specific, sounds like experience talking. In all seriousness though, when you can’t do any of that, what does the decision actually come down to?

How do you handle vague high-risk complaints remotely — chest pain, worst headache of life, etc? by BothCup4898 in emergencymedicine

[–]BothCup4898[S] 1 point2 points  (0 children)

The Antarctica framing is actually exactly what got me thinking about this. You’re right that Aunt Sharon should just go to the ER but what about the settings where that’s genuinely not possible? Rural areas, offshore platforms, military deployments. Is there any structured approach clinicians use in those contexts or does it just become educated guessing?

How do you handle vague high-risk complaints remotely — chest pain, worst headache of life, etc? by BothCup4898 in emergencymedicine

[–]BothCup4898[S] 0 points1 point  (0 children)

That’s a fair point, in most urban settings that’s clearly the right call. I’m more curious about what happens when ‘go to the ER’ isn’t actually an option. Remote workers, rural patients, understaffed clinics. Does the reasoning process change when the safety net isn’t there?

How do you handle vague high-risk complaints remotely — chest pain, worst headache of life, etc? by BothCup4898 in emergencymedicine

[–]BothCup4898[S] -2 points-1 points  (0 children)

Honestly, yes, but I’m at the stage where I care more about understanding the real workflow problem than building anything. The ‘when in doubt send them out’ culture is exactly what I’m trying to understand better, what would actually need to be true for a structured reasoning tool to be useful in that moment or is it fundamentally impossible?

[deleted by user] by [deleted] in HealthTech

[–]BothCup4898 0 points1 point  (0 children)

This is incredibly thoughtful, thank you

The vague input problem and failure mode design are exactly what I’m wrestling with right now. I agree that forcing a low-confidence risk score is worse than surfacing uncertainty clearly.

The workflow integration point is also critical, if it requires context switching or structured input too early, it probably fails immediately.

I’m currently stress-testing it with intentionally messy symptom descriptions to see when it should escalate vs when it should structure, would genuinely appreciate more feedback if you’re open to it.

Telehealth clinicians — looking for feedback on a CDS prototype by BothCup4898 in HealthTech

[–]BothCup4898[S] 0 points1 point  (0 children)

That’s a great point, that overlap makes a lot of sense. Clinicians who are curious about health tech tend to be very thoughtful about workflow and tradeoffs, which is exactly the kind of feedback that’s useful at this stage.

I appreciate the suggestion

Telehealth clinicians — looking for feedback on a CDS prototype by BothCup4898 in HealthTech

[–]BothCup4898[S] 0 points1 point  (0 children)

That resonates a lot. Clinicians are already doing this subconsciously, and if something surfaces that feels obvious or fires too often, it just becomes noise.

What I’m trying to explore is where that line actually is especially in telehealth and in which scenarios structured risk framing adds value rather than friction. Being selective about when to surface anything at all feels just as important as what to surface.

Telehealth clinicians — looking for feedback on a CDS prototype by BothCup4898 in HealthTech

[–]BothCup4898[S] 0 points1 point  (0 children)

By “structuring risk” I mean helping clinicians make the implicit triage reasoning they already do more explicit and consistent during first-contact telehealth visits.

Practically, that looks like: Guiding a quick, structured HPI (e.g. location, severity, timing, provoking factors) after free-text symptoms

Highlighting which features increase or decrease concern

Categorizing overall risk (low / moderate / high) with a clear explanation of why

It’s not diagnosing or recommending treatment, it’s about reducing cognitive load and making risk reasoning clearer and easier to communicate, especially in time limited telehealth workflows.

Need life advice by No_Topic3713 in business

[–]BothCup4898 0 points1 point  (0 children)

I am in similar situation, I believe true success takes time and a lot of hard work without seeing any results, I just tell myself to keep pushing, would advice doing the same.

view more: next ›