Clinical Metagenomic Sequencing for Diagnosis of Meningitis and Encephalitis | NEJM nejm.org/doi/full/10.10…
Of 204 cases, there were 13 cases where a pathogen was identified by metagenomic sequencing alone, and 7 of those results changed management.
Small yield for applying this technology to such a large sample of patients, especially since metagenomic sequencing alone missed 26 pathogens detected by routine tests.
Likely a helpful technology in the future, but unclear how much additional information it provides right now, especially given the amount of input and discussion needed to interpret these results.
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1/ Your team just saw a patient with syphilis, and you're ready to teach, but:
Resident #1: on week 2 of their rotation
👉 Has already seen 2 patients w/ syphilis
Resident #2: started today
👉 Hasn't seen a single patient with syphilis
What should you do now?
2/ Unfortunately, learners on our team may miss teaching that occurs during the rotation for multiple reasons.
3/ As @VarunPhadke2 previously pointed out, all learners on the team are usually not present all day, every day for the entire time we are on clinical services.