Special Article |

Evidence and the Effective Clinical Neurologist:  The 2009 H. Houston Merritt Lecture

Louis R. Caplan, MD
Arch Neurol. 2011;68(10):1252-1256. doi:10.1001/archneurol.2011.237.
Text Size: A A A
Published online


For generations, neurologists have been trained to test their clinical hypotheses by obtaining detailed histories and performing neurological examinations to arrive at a complete differential diagnosis. Additional investigations and imaging narrow the diagnoses to those pertinent to the patient. Choice of therapy considers the benefits and risks of each potential treatment for that complex individual. It is necessary to have substantial knowledge about the patient and his or her social milieu and psychological makeup. This approach can be characterized as “personalized medicine” because it emphasizes the medical and personal details of each individual. This system was taught by Dr H. Houston Merritt (Figure 1), for whom this lecture is named, and by myself and my mentors in neurology; furthermore, it is the backbone of a monograph by me and Joshua Hollander titled The Effective Clinical Neurologist, now in its third edition.1

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Graphic Jump Location

Figure 1. Dr H. Houston Merritt. From Rowland LP. The Legacy of Tracy J. Putnam and H. Houston Merritt: Modern Neurology in the United States. Oxford, England: Oxford University Press; 2009.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. Computed tomographic image showing hyperdense internal carotid and middle cerebral arteries (arrow).

Place holder to copy figure label and caption
Graphic Jump Location

Figure 3. Computed tomographic angiogram showing a filling defect representing a thrombus (white arrow) in the proximal vertebral artery.




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles