Decision Making by Analogy

Abstract

In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.A 27-year-old woman with a history of seizures since childhood was brought to the emergency department because of sharp left anterior pleuritic chest pain, a productive cough, increasingly severe shortness of breath, nausea, and one episode of vomiting. She had no fever, chills, sweats, diarrhea, dysuria, edema, orthopnea, or weight change. She had been ill only one day. The New England Journal of Medicine Downloaded from nejm.org at PRINCETON UNIVERSITY on August 11, 2015. For personal use only. No other uses without permission.