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Initial Methodologic Considerations for the Critical Assessment of Medical Interventions Performed by Physicians

Mary-Margaret Chren, MD

Arch Dermatol. 1994;130(8):1052-1054.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

I CAN WRITE WITH some experience about dermatologic consultations, since I requested so many while still an internist. Risking national ridicule, I will relate one of my experiences. Wondering if a patient with ''osteoarthritis'' and a scaly plaque perhaps had psoriasis and psoriatic arthritis, I began treating her with a midpotency topical corticosteroid and asked a dermatologist to see her. The consultation note, which was a treatise repeating the lengthy history that I knew, ended with ''Imp: LSC. Rec: Fluocinonide cream 0.05% bid.'' (a higher-potency topical corticosteroid). Once I had translated the abbreviation and looked up lichen simplex chronicus to learn that it is a localized plaque created by repeated scratching, I am sure that the consultants and I differed about the value of this consultation and my knowledge of simple skin diseases. True, the diagnosis had changed, the therapy had changed, and I had been wrong, but I was . . . [Full Text PDF of this Article]

Author Affiliations
Department of Dermatology University Hospitals of Cleveland Cleveland Veterans Affairs Medical Center 11-G (W) 10701 East Blvd Cleveland, OH 44106

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