Clinical Reasoning and Risk in the Intensive Care Unit

Clinical reasoning in medicine describes the process whereby a clinician gathers, assimilates, and assesses information about a person and their illness to assign a diagnosis and institute therapy. Care of patients in the intensive care unit involves managing a substantial quantity of incomplete, novel, and rapidly changing data. A modified nine-step bayesian approach to clinical reasoning comports well with this complex environment and is useful for assisting and educating novice learners to apply clinical reasoning accurately and consistently. When combined with a sophisticated approach to risk-benefit analysis to modify the treatment threshold, it becomes a useful and insightful tool for clinicians and those working in medical education.