APPLYING EVIDENCE TO INDIVIDUAL CASE MANAGEMENT: AN ILLUSTRATIVE EXAMPLE OF CONSERVATIVE VERSUS SURGICAL TREATMENT OF THORACIC OUTLET SYNDROME

Main Article Content

Megan Rabe
Peter Emary

Keywords

Evidence-Based Practice, Evidence-Based Case Report, Thoracic Outlet Syndrome

Abstract

Objective: To illustrate how research findings can be used to inform the management of an individual patient.


Methods: A case scenario of a 29-year-old pregnant woman with a diagnosis of thoracic outlet syndrome (TOS) evoked a search of the PubMed database resulting in one randomized controlled trial (RCT) relevant to conservative versus surgical treatment. No systematic reviews were found. We appraised the RCT for its validity, importance, and applicability to informing a treatment plan for the patient.


Results: Surgical intervention for TOS was found to be favorable over conservative treatment. Combining the results with our patient’s clinical state and circumstances, we concluded that conservative therapy for the duration of her pregnancy should be recommended. Progressive neurological deficits or lack of symptom improvement six months post-partum would indicate a referral to her family physician for further evaluation and management.


Conclusion: We applied evidence from 1 recent RCT in formulating a management plan for a case of TOS.

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