Clinical Medicine

A sore throat is one of the most common reasons anyone walks into a primary care office or urgent care clinic, and the actual clinical question underneath it is usually narrow: is this one of the minority of sore throats caused by group A Streptococcus, where antibiotics might genuinely help, or is it one of the many more that are viral, where antibiotics do nothing…

Ask ten clinicians what “sick” means and you’ll get ten different answers, which becomes a real problem the moment you try to compare outcomes across groups of patients in a study. The Charlson Comorbidity Index (CCI) was built in 1987 to solve exactly that problem: a simple, reproducible way to summarize how much chronic disease a patient is carrying into a study, a chart review,…

If you’ve spent any time around a hepatology or transplant service, you’ve heard someone rattle off a MELD score like it’s a vital sign. In a sense, it is one — just for the liver instead of the heart or lungs. The Model for End-Stage Liver Disease, or MELD, turns three lab values most patients with cirrhosis already have on their chart — bilirubin, INR,…

For years, the standard equation for estimating kidney function from a blood test included a coefficient that adjusted the result upward for patients identified as Black — an adjustment built on a generalization about muscle mass and creatinine production, rather than anything measured in the individual patient. In 2021, that changed. Here’s what the new equation does differently, and why it matters. What eGFR is,…

Pulmonary embolism is one of the great “can’t miss” diagnoses in emergency medicine, and also one of the easiest to over-test for — not every patient with chest pain or shortness of breath needs a CT scan, but nobody wants to be the clinician who sent a real PE home. Wells’ Criteria is the seven-item score most departments use to get out of that bind:…