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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Heart Failure
Robert G. Badgett, Catherine R. Lucey, Najib Ayas, Sheri Keitz
Make the Diagnosis: Heart Failure


Topics Discussed: congestive heart failure, criterion standard comparisons (diagnostic tests), heart failure, likelihood ratio, make the diagnosis, prior probability, ventricular dysfunction, left

Excerpt: "A broad range of prior probabilities (10%-40%) is required for clinical decisions, with outpatients who have suggestive symptoms at the lower end of the range and inpatients toward the upper end. The patient with dyspnea who presents to the emergency department without an obvious cause for dyspnea has about a 50% probability of left ventricular dysfunction (range, 34%-83%)...."
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