Importance Of Thorough Physical Examination: A Lost Art

Asif, Talal; Mohiuddin, Amena; Hasan, Badar; Pauly, Rebecca

doi:10.7759/cureus.1212

Cited by 29 publications

(29 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At 03:40, when the patient had progressive dyspnea and the resident ordered treatment for asthma over the phone, if he had gone to see the patient, he might have appreciated the severity of her illness and started more aggressive therapy, again potentially changing the outcome. The analysis of this case and others [ 2 ] suggests that likely nothing is better for patient safety than good in-person history and physical examination.…”

Section: Discussionmentioning

confidence: 81%

A Psychiatrist with Postoperative Anxiety After Hysterectomy: How Could This Be Fatal?

Nichols

McNeal

Callins

2019

Cureus

View full text Add to dashboard Cite

Hysterectomy is a common surgery and rarely fatal. Here, we present a case of hysterectomy with postoperative complications, leading to a fatal outcome. The autopsy revealed the cause of death and clinicopathologic correlation suggested multiple lessons for patient safety. Patient safety can be enhanced by appropriate boundaries in the care of physician-patients, proactive monitoring and prompt treatment of postoperative asthma, nasogastric suction for postoperative ileus associated with vomiting, and assessment of the patient situation by a good history and physical examination, going to see the patient in person.

show abstract

Section: Discussionmentioning

confidence: 81%

A Psychiatrist with Postoperative Anxiety After Hysterectomy: How Could This Be Fatal?

Nichols

McNeal

Callins

2019

Cureus

View full text Add to dashboard Cite

show abstract

“…Although examples have been applied clinically in various medical fields, clear test protocols, such as diagnostic imaging, blood sampling, genetic testing, electroencephalograms, and electrocardiograms, are still required [ 18 , 19 ]. Conversely, in daily practice, doctors tend to place less emphasis on physical examinations that provide only subjective records and place greater emphasis on blood sampling or imaging tests that provide objective results [ 20 ]. Conventional physical examination findings and other physical results are subjective, making it difficult for examiners to vary examination techniques and compare findings with past results to make assessments simply and quickly.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Hemodialysis Arteriovenous Bruit by Deep Learning

Ota

Nishiura

Ishihara

et al. 2020

Sensors

View full text Add to dashboard Cite

Physical findings of auscultation cannot be quantified at the arteriovenous fistula examination site during daily dialysis treatment. Consequently, minute changes over time cannot be recorded based only on subjective observations. In this study, we sought to supplement the daily arteriovenous fistula consultation for hemodialysis patients by recording the sounds made by the arteriovenous fistula and evaluating the sounds using deep learning methods to provide an objective index. We sampled arteriovenous fistula auscultation sounds (192 kHz, 24 bits) recorded over 1 min from 20 patients. We also extracted arteriovenous fistula sounds for each heartbeat without environmental sound by using a convolutional neural network (CNN) model, which was made by comparing these sound patterns with 5000 environmental sounds. The extracted single-heartbeat arteriovenous fistula sounds were sent to a spectrogram and scored using a CNN learning model with bidirectional long short-term memory, in which the degree of arteriovenous fistula stenosis was assigned to one of five sound types (i.e., normal, hard, high, intermittent, and whistling). After 100 training epochs, the method exhibited an accuracy rate of 70–93%. According to the receiver operating characteristic (ROC) curve, the area under the ROC curves (AUC) was 0.75–0.92. The analysis of arteriovenous fistula sound using deep learning has the potential to be used as an objective index in daily medical care.

show abstract

“…Deterioration of clinical examination skills among medical practitioners has been attributed to improvements in technology and a lack of time to properly examine patients. 8,9 However, especially in resourcerestricted countries, a thorough clinical examination remains an important skill in the armamentarium of healthcare professionals. It is postulated that the clinical examination component of an examination allows for evaluation of the effectiveness of a training programme and acts as a screening device to identify inadequately trained candidates.…”

Section: Discussionmentioning

confidence: 99%

The FC Orth(SA) final examination: how effective is the written component?

et al. 2018

View full text Add to dashboard Cite

Background: To determine the pass rate of the final exit examination of the College of Orthopaedic Surgeons of South Africa [FC Orth(SA)] and to assess the correlation between the written component with the clinical and oral component. Methods: Results of candidates who participated in the FC Orth(SA) final examination during a 12-year period from March 2005 through to November 2016 were assessed retrospectively. Pass rates and component averages were analysed using descriptive and inferential statistics. Spearman's rho test was used to determine the correlation between the components. Results: A total of 399 candidates made 541 attempts at the written component of the examination; 71.5% of attempts were successful and 387 candidates were invited to the clinical and oral component, of which 341 (88%) candidates were certified. The second-attempt pass rate for those candidates who wrote the written component again was 42%. The average annual increase in the number of certified candidates was 8.5%. The overall certifying rate increased by 1.5% for this period. Invited candidates who scored less than 54% for the written component were at significant risk of failing the clinical and oral component. The written component showed weak correlation with the clinical and oral component (r=0.48). Conclusion: While the written component was found to be an effective gatekeeper, as evidenced by a high eventual certifying rate, the results of this component of the FC Orth(SA) final examination did not correlate strongly with the performance in the clinical and oral component. This finding confirms the value of the written component as part of a comprehensive assessment for the quality of orthopaedic surgeons.

show abstract

Importance Of Thorough Physical Examination: A Lost Art

Cited by 29 publications

References 8 publications

A Psychiatrist with Postoperative Anxiety After Hysterectomy: How Could This Be Fatal?

A Psychiatrist with Postoperative Anxiety After Hysterectomy: How Could This Be Fatal?

Evaluation of Hemodialysis Arteriovenous Bruit by Deep Learning

The FC Orth(SA) final examination: how effective is the written component?

Contact Info

Product

Resources

About