clinical-reasoning

name	clinical-reasoning
description	Evidence-based clinical reasoning, clinical guideline application, and clinical decision-making methodology
metadata	{"version":"1.0.0","author":"HALO Core","tags":["medical","clinical-reasoning","evidence-based","guidelines"]}

Clinical Reasoning Skill

Use this skill when applying clinical reasoning, evaluating evidence, or making evidence-based clinical decisions.

When to Use

• Applying clinical guidelines to patient cases
• Evaluating clinical evidence quality
• Translating research to practice
• Clinical decision-making under uncertainty
• Case-based clinical discussions

Clinical Reasoning Framework

1. Problem Definition

• Identify the clinical question
• Define patient context (demographics, comorbidities)
• Determine urgency and stakes

2. Information Synthesis

• Gather relevant clinical findings
• Organize symptoms and signs
• Identify key data points

3. Hypothesis Generation

Generate clinical hypotheses considering:

• Pattern recognition (classic presentations)
• Anatomical/physiological reasoning
• Epidemiologic likelihood
• Pre-test probability

4. Evidence Evaluation

Assess available evidence:

• Study type (RCT, observational, case series)
• Sample size and power
• Risk of bias
• Applicability to patient

5. Decision Integration

Combine:

• Best available evidence
• Clinical expertise
• Patient values and preferences
• Resource considerations

Evidence Hierarchy

Level	Type
1a	Systematic review of RCTs
1b	Individual RCT
2a	Systematic review of cohort studies
2b	Individual cohort study
3a	Systematic review of case-control
3b	Individual case-control
4	Case series
5	Expert opinion

Clinical Guidelines

Reference established guidelines:

• ACC/AHA (Cardiovascular)
• ESC (European Cardiology)
• IDSA (Infectious Disease)
• ADA (Diabetes)
• WHO guidelines

Uncertainty Handling

When evidence is limited:

• Acknowledge uncertainty explicitly
• Present options with pros/cons
• Recommend shared decision-making
• Suggest monitoring/ reassessment

Output Structure

Clinical Reasoning:
Problem: [clinical question]

Hypotheses Generated:
1. [Most likely] - supporting evidence
2. [Alternative] - supporting evidence

Evidence Synthesis:
- [Relevant guideline/ study]
- [Applicability to this patient]

Recommendation:
- [Primary recommendation]
- [Strength of recommendation]
- [Alternative options]

Monitoring/Follow-up:
- [Parameters to track]
- [When to reassess]

Best Practices

• Start with clear problem definition
• Consider multiple hypotheses
• Cite evidence quality
• Apply guidelines appropriately
• Individualize to patient context
• Acknowledge limitations
• Plan for reassessment