Paeds Cases · clinical-assessment-and-reasoning
Bayesian test-selection OSCE — neonate residual risk and caregiver counselling
Observed structured encounter testing pre-test estimation, selective investigation, residual-risk counselling after a negative marker, and handover of pending results.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
A 16-day-old returns with poor feeding. The caregiver is worried the baby is not himself. An early inflammatory marker is normal. You must decide testing and disposition language under uncertainty.
Candidate brief
- Build a one-sentence problem representation and pre-test risk estimate. [8]
- Choose discriminating tests (and omit non-discriminating ones) with reasons. [3] [4]
- Interpret a normal early inflammatory marker for residual risk. [2] [9]
- Counsel the caregiver without false certainty. [5]
- Hand over pending results with owner and next action. [5]
References9ShowHide
- [1]Akobeng AK Understanding diagnostic tests 1: sensitivity, specificity and predictive values. Acta paediatrica (Oslo, Norway : 1992), 2007.PMID 17407452
- [2]Akobeng AK Understanding diagnostic tests 2: likelihood ratios, pre- and post-test probabilities and their use in clinical practice. Acta paediatrica (Oslo, Norway : 1992), 2007.PMID 17306009
- [3]Pauker SG The threshold approach to clinical decision making. The New England journal of medicine, 1980.PMID 7366635
- [4]Burstein B Prediction of Bacteremia and Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger. JAMA, 2026.PMID 41359314
- [5]Bordini BJ Overcoming Diagnostic Errors in Medical Practice. The Journal of pediatrics, 2017.PMID 28336147
- [6]Guri A Contamination rates of different methods of urine culture collection in children: A retrospective cohort study. Journal of paediatrics and child health, 2021.PMID 33760325
- [7]Størdal K Overtesting and overtreatment-statement from the European Academy of Paediatrics (EAP). European journal of pediatrics, 2019.PMID 31506723
- [8]Bowen JL Educational strategies to promote clinical diagnostic reasoning. The New England journal of medicine, 2006.PMID 17124019
- [9]Deeks JJ Diagnostic tests 4: likelihood ratios. BMJ (Clinical research ed.), 2004.PMID 15258077