Meet the Patient

Every clinical challenge begins with a patient. Read the clinical scenario carefully, identify the clinical uncertainty, and then begin the Hour of Clinical Evidence Challenge.

Case 001 – Acute Ischemic Stroke

Clinical Scenario

A 68-year-old man is brought to the emergency department 2 hours after suddenly developing right-sided weakness and slurred speech. He has a history of hypertension and type 2 diabetes. A non-contrast CT scan shows no evidence of intracranial hemorrhage. The emergency physician wants to determine the most appropriate evidence-informed management to improve the patient's functional outcome.

Case 002 – Heart Failure with Reduced Ejection Fraction

Clinical Scenario

A 72-year-old woman with chronic heart failure presents with worsening breathlessness despite guideline-directed medical therapy. Echocardiography shows an ejection fraction of 30%. The treating cardiologist wants to identify the most appropriate evidence-informed strategy to improve symptoms, reduce hospitalization and improve survival.

Case 003 – Chronic Low Back Pain

Clinical Scenario

A 56-year-old office worker has experienced chronic non-specific low back pain for the past eight months. Pain continues to interfere with work and daily activities despite analgesics. The rehabilitation physician wants to determine the most effective evidence-informed management to improve pain and functional ability.

Case 004 – Acute Exacerbation of COPD

Clinical Scenario

A 65-year-old man with chronic obstructive pulmonary disease presents with increasing breathlessness, productive cough and wheeze over the previous three days. The treating physician wants to identify the most appropriate evidence-informed management to improve recovery and reduce complications.

Case 005 – Type 2 Diabetes Mellitus

Clinical Scenario

A 52-year-old woman with poorly controlled type 2 diabetes has an HbA1c of 9.2% despite taking metformin regularly. She is overweight and has hypertension. The physician wants to determine the most appropriate evidence-informed management to improve glycaemic control and reduce future cardiovascular complications.

Case 006 – Community-Acquired Pneumonia

Clinical Scenario

A 60-year-old man presents with fever, productive cough, pleuritic chest pain and shortness of breath for three days. Chest radiography confirms community-acquired pneumonia. The treating physician wants to determine the most appropriate evidence-informed antibiotic regimen and supportive management to improve clinical recovery.

Case 007 – Knee Osteoarthritis

Clinical Scenario

A 64-year-old woman has chronic bilateral knee pain that worsens while climbing stairs and walking long distances. Radiographs confirm knee osteoarthritis. The rehabilitation physician wants to determine the most appropriate evidence-informed non-surgical management to reduce pain and improve physical function.

Case 008 – Chronic Kidney Disease

Clinical Scenario

A 58-year-old man with hypertension and type 2 diabetes has an eGFR of 42 mL/min/1.73 m² with persistent albuminuria. The nephrologist wants to determine the most appropriate evidence-informed treatment strategy to slow kidney disease progression and reduce cardiovascular complications.

Case 009 – Iron Deficiency Anaemia

Clinical Scenario

A 35-year-old woman presents with fatigue, exertional breathlessness and reduced exercise tolerance. Laboratory investigations reveal microcytic hypochromic anaemia with low serum ferritin. The physician wants to determine the most appropriate evidence-informed diagnostic work-up and treatment strategy.

Case 010 – Major Depressive Disorder

Clinical Scenario

A 29-year-old woman has persistent low mood, loss of interest, disturbed sleep and poor concentration for the past two months. She has no suicidal ideation. The psychiatrist wants to determine the most appropriate evidence-informed treatment approach to achieve remission and prevent relapse.

Case 011 – Childhood Asthma

Clinical Scenario

An 8-year-old boy experiences recurrent wheezing and nighttime cough despite using a short-acting bronchodilator as needed. The pediatrician wants to determine the most appropriate evidence-informed long-term controller therapy to improve asthma control and reduce future exacerbations.

Case 012 – Urinary Tract Infection in Pregnancy

Clinical Scenario

A 26-year-old woman at 22 weeks of pregnancy presents with dysuria and urinary frequency. Urine culture confirms Escherichia coli infection. The obstetrician wants to determine the most appropriate evidence-informed antibiotic treatment that is both effective and safe during pregnancy.

Case 013 – Acute Appendicitis

Clinical Scenario

A 24-year-old man presents with right lower quadrant abdominal pain, fever and nausea. Imaging confirms uncomplicated acute appendicitis. The surgeon wants to determine the most appropriate evidence-informed management to achieve the best clinical outcome.

Case 014 – Rheumatoid Arthritis

Clinical Scenario

A 42-year-old woman presents with symmetrical pain and swelling of the small joints of both hands accompanied by morning stiffness lasting more than one hour. The rheumatologist wants to determine the most appropriate evidence-informed treatment strategy to control disease activity and prevent long-term joint damage.

Case 015 – Sepsis

Clinical Scenario

A 70-year-old man presents with fever, hypotension, tachycardia and altered mental status secondary to suspected bacterial infection. The intensive care physician wants to determine the most appropriate evidence-informed early management strategy to improve survival and reduce organ dysfunction.

Ready to Think Like an Evidence-Based Clinician?

Select a patient, complete the six-step Hour of Clinical Evidence™ Challenge, and generate your own Clinical Evidence Report.