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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 79-year-old man was referred to our hospital because of an 18-kg weight loss over the previous six months. Seven months before admission, his house burned down, and insomnia, anorexia, and anhedonia developed. One month before admission, he began having diffuse, episodic, dull abdominal pain without radiation, relation to food or position, or improvement with the use of a proton-pump inhibitor. The
Commentary
Source Information
From the Center for Primary Care and Outcomes Research, Stanford University, Stanford, Calif. (J.H.); the Department of Medicine, University of California, San Francisco (N.N.T.); and the Department of Medicine, San Francisco Veterans Affairs Medical Center, San Francisco (J.K., L.T.).
Address reprint requests to Dr. Haberer at the Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 94305, or at haberer@healthpolicy.stanford.edu.
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