-
BMC Pregnancy and Childbirth Jul 2020The purpose of this study was to compare the reliability and reproducibility of the traditional qualitative method of assessing uterine cervical stiffness with those of...
BACKGROUND
The purpose of this study was to compare the reliability and reproducibility of the traditional qualitative method of assessing uterine cervical stiffness with those of a quantitative method using a novel device based on the aspiration technique.
METHODS
Five silicone models of the uterine cervix were created and used to simulate different cervical stiffnesses throughout gestation. The stiffness of the five cervix models was assessed both by digital palpation (firm, medium and soft) and with the Pregnolia System. Five self-trained participants conducted the device-based assessment, whereas 63 obstetricians and midwives, trained in digital palpation, conducted the cervical palpation.
RESULTS
The results of the two methods were analyzed in terms of inter-and intra-observer variability. For digital palpation, there was no common agreement on the assessment of the stiffness, except for the softest cervix. When assessing the same cervix model for a second time, 76% of the obstetricians and midwives disagreed with their previous assessment. In contrast, the maximum standard deviation for the device-based stiffness assessment for intra- and inter-observer variability was 3% and 3.4%, respectively.
CONCLUSIONS
This study has shown that a device based on the aspiration technique provides obstetricians and midwives with a method for objectively and repeatably assess uterine cervical stiffness, which can eliminate the need to rely solely on a subjective interpretation, as is the case with digital palpation.
Topics: Cervical Ripening; Cervix Uteri; Female; Humans; Models, Anatomic; Observer Variation; Palpation; Pregnancy; Reproducibility of Results; Suction
PubMed: 32631265
DOI: 10.1186/s12884-020-03080-x -
Medicina (Kaunas, Lithuania) Mar 2021: The techniques directed to the cranial field in osteopathy are the most questioned due to the lack of scientific evidence. In osteopathic practice, manual palpation is...
: The techniques directed to the cranial field in osteopathy are the most questioned due to the lack of scientific evidence. In osteopathic practice, manual palpation is essential and, therefore, measuring reliability is fundamental. The objective of this study is to assess the precision and objectification of an educational model in cranial osteopathy based on experience. : A reliability study was conducted in a cadaver skull where a strain gauge was placed on the sphenobasilar synchondrosis (SBS) of the base of the skull. Three cranial osteopathic techniques (lateral compression, anteroposterior compression, and compression maneuver of the mastoids) were performed 25 times by osteopaths with different degrees of experience (5-10 years, 1-5 years, <1 year). Measurements were computed for each of the three techniques of each group in comparison with the osteopath with >15 years of experience. Data were analyzed to check for inter- and intra-observer reliability using intra-class correlation coefficients (ICC). : Reliability in osteopaths with 5-10 years' experience (observer 1 and observer 2) performing all three techniques was higher ( < 0.001) than the osteopath with >15 years' experience. Little or no reliability were observed in osteopaths with less experience. : The experience of the osteopaths determines the reliability and effectiveness of the cranial techniques, a fundamental part in objectifying these techniques. This model can help implement objective training in cranial osteopathy formation.
Topics: Humans; Manipulation, Osteopathic; Models, Educational; Osteopathic Physicians; Palpation; Reproducibility of Results
PubMed: 33808011
DOI: 10.3390/medicina57030246 -
Ultrasound in Obstetrics & Gynecology :... Jun 2016To study the correlation between palpation, perineometry and transperineal ultrasound for assessment of pelvic floor muscle contraction and to define a contraction scale...
OBJECTIVE
To study the correlation between palpation, perineometry and transperineal ultrasound for assessment of pelvic floor muscle contraction and to define a contraction scale for ultrasound measurements.
METHODS
This was a cross-sectional study of 608 women examined with palpation of pelvic floor muscle contraction, using the Modified Oxford Scale, and measurement of the vaginal squeeze pressure with a vaginal balloon connected to a fiber-optic microtip transducer (perineometry). Transperineal ultrasound was used for measurements of levator hiatal area and anteroposterior (AP) diameter in the plane of minimal hiatal dimensions, at rest and on contraction. The pelvic floor muscle contraction was expressed as the percentage difference between values at rest and on contraction. Spearman's rank was used to test for correlation between the different methods of assessment.
RESULTS
Significant correlations were found between all assessment methods (P < 0.001). Palpation correlated with perineometry (rs = 0.74) and with proportional change in hiatal area (rs = 0.67) and AP diameter (rs = 0.69) on ultrasound. Perineometry correlated with proportional change in hiatal area (rs = 0.60) and AP diameter (rs = 0.66) on ultrasound. We defined a contraction scale based on the proportional change in AP diameter. In this population, a change in AP diameter of < 7% corresponded to absence of contractions, 7-18% corresponded to weak contractions, 18-35% corresponded to normal contractions and > 35% corresponded to strong contractions.
CONCLUSIONS
We found moderate to strong correlation between ultrasound measurements, palpation and perineometry for assessing pelvic floor muscle contraction. The proportional change in levator hiatal AP diameter was the ultrasound measurement with strongest correlation to palpation and perineometry and formed the basis for the contraction scale for ultrasound measurements. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Imaging, Three-Dimensional; Middle Aged; Muscle Contraction; Muscle, Skeletal; Palpation; Pelvic Floor; Ultrasonography
PubMed: 26300128
DOI: 10.1002/uog.15731 -
Journal of the National Medical... Mar 1978The purpose of this report is to review personal experience with digital palpation of the nasopharynx, particularly as it relates to an apparently reversible posterior...
The purpose of this report is to review personal experience with digital palpation of the nasopharynx, particularly as it relates to an apparently reversible posterior pharyngeal mass commonly found in patients who are heavy smokers.
Topics: Adult; Female; Humans; Male; Middle Aged; Nasopharyngeal Diseases; Nasopharyngeal Neoplasms; Palpation; Smoking
PubMed: 691080
DOI: No ID Found -
Proceedings of the Institution of... May 2023A calibrated palpation sensor has been developed for making instrumented Digital Rectal Examinations (iDREs) with a view to assessing patients for prostate cancer. The...
A calibrated palpation sensor has been developed for making instrumented Digital Rectal Examinations (iDREs) with a view to assessing patients for prostate cancer. The instrument measures the dynamic stiffness of the palpable surface of the prostate, and has been trialled on 12 patients in vivo. The patients had been diagnosed with prostate cancer and were scheduled for radical prostatectomy. As far as possible, patients with asymmetric disease were chosen so as to give a variation in gland condition over the palpable surface. The device works by applying an oscillating pressure (force) to a flexible probe whose displacement into the tissue is also measured in order to yield a dynamic stiffness, the static stiffness being incidentally measured at the mean oscillatory force. The device was deployed mounted on the index finger of a urologist and measurements taken at 12-16 positions on each patient using light and firm pressure and palpation frequencies of 1 or 5 Hz. In parallel, conventional DRE assessments were made by a consultant urologist for cancer. After in vivo measurement, the glands were removed and examined histologically with each palpation point being classified as cancerous (C) or not (NC). The work has established the first measurements of static modulus of living prostate tissue to be: 26.8 (13.3) kPa for tissue affected by prostate cancer (C classification), and 24.8 kPa (11.9) for tissue unaffected by cancer (NC classification), values quoted as median (interquartile range). The dynamic properties were characterised by: dynamic modulus, 5.15 kPa (4.86) for the C classification and 4.61 kPa (3.08) for the NC classification and the time lag between force and displacement at 5 Hz palpation frequency, 0.0175 s (0.0078) for the C classification and 0.0186 s (0.0397) for the NC classification, values again quoted as median (interquartile range). With the limited set of features that could be generated, an Artificial Neural Network (ANN) classification yielded a sensitivity of 97%, negative predictive value of 86%, positive predictive value of 67% and accuracy of 70% but with relatively poor specificity (30%). Besides extending the feature set, there are a number of changes in probe design, probing strategy and in mechanics analysis, which are expected to improve the diagnostic capabilities of the method.
Topics: Male; Humans; Prostate; Prostatic Neoplasms; Palpation; Mechanical Phenomena
PubMed: 37062899
DOI: 10.1177/09544119231154305 -
Theriogenology Mar 2017The objectives of the present investigation were to evaluate the pregnancy diagnosis by detection of either the allantochorion membrane (FMS) or amniotic sac (ASP) by... (Comparative Study)
Comparative Study
Comparison between allantochorion membrane and amniotic sac detection by per rectal palpation for pregnancy diagnosis on pregnancy loss, calving rates, and abnormalities in newborn calves.
The objectives of the present investigation were to evaluate the pregnancy diagnosis by detection of either the allantochorion membrane (FMS) or amniotic sac (ASP) by per rectum palpation (PRP) during late embryonic or early fetal period on pregnancy loss (PRL) at reexamination, calving rates, and abnormalities in newborn calves. A controlled randomized blind design with 800 lactating dairy pregnant cows diagnosed by transrectal ultrasonography (TRUS) between Days 35 and 57 of gestation from one dairy farm were included. The cows were randomly divided according to detection of allantochorion membrane (FMS group; n = 264), detection of amniotic sac (ASP group; n = 266), and TRUS (control [CON] group; n = 270). TRUS was considered as the criterion standard method of comparison. The entire PRP was performed by one experienced veterinarian. Then, all the cows were reexamined only by TRUS between 2 and 4 weeks later by two independent veterinarians to assess PRL. The calving rate one (number of cows calved divided by the number of cows initially pregnant) and calving rate two (number of cows calved divided by the number of cows pregnant at reexamination) for each group was calculated. All abortions and stillborns were necropsied, and calves alive were followed for 5 days. The overall initial PRL (between initial pregnant cows and reexamination) for FMS, ASP, and CON groups was 7.4% (19/258), 8.8% (23/262), and 9.2% (24/260), respectively (P = 0.75). The overall late PRL (between reexamination and calving) for FMS, ASP, and CON groups was 4.2% (9/213), 5.7% (12/209), and 4.2% (9/216), respectively (P = 0.71). The calving rate one for FMS, ASP, and TRUS groups was 79.1% (204/258), 75.2% (197/262), and 79.6% (207/260), respectively (P = 0.63). The calving rate two for the same groups was 85.4% (204/239), 82.4% (197/239), and 87.7% (207/236), respectively (P = 0.27). The number of fetuses aborted late, premature, and mature dead from FMS, ASP, and CON groups was 6, 4, and 5, respectively (P = 0.85), and no abnormalities at necropsy were detected. One stillborn male calf with atresia coli after 281 days of gestation from a cow examined by ASP at Day 51 was diagnosed. It was concluded that the use of either FMS or ASP for pregnancy diagnosis during late embryonic or early fetal period did not increase the PRL, affect calving rates, or produce calves with congenital abnormalities.
Topics: Abortion, Veterinary; Animals; Animals, Newborn; Birth Rate; Cattle; Cattle Diseases; Digital Rectal Examination; Female; Intestinal Atresia; Male; Pregnancy; Pregnancy Tests
PubMed: 28166972
DOI: 10.1016/j.theriogenology.2016.11.004 -
Soft Robotics Apr 2022Medical palpation is a diagnostic technique in which physicians use the sense of touch to manipulate the soft human tissue. This can be done to enable the diagnosis of...
Medical palpation is a diagnostic technique in which physicians use the sense of touch to manipulate the soft human tissue. This can be done to enable the diagnosis of possibly life-threatening conditions, such as cancer. Palpation is still poorly understood because of the complex interaction dynamics between the practitioners' hands and the soft human body. To understand this complex of soft body interactions, we explore robotic palpation for the purpose of diagnosing the presence of abnormal inclusions, or tumors. Using a Bayesian framework for training and classification, we show that the exploration of soft bodies requires complex, multi-axis, palpation trajectories. We also find that this probabilistic approach is capable of rapidly searching the large action space of the robot. This work progresses "robotic" palpation, and it provides frameworks for understanding and exploiting soft body interactions.
Topics: Bayes Theorem; Humans; Palpation; Robotics; Touch; Touch Perception
PubMed: 34432994
DOI: 10.1089/soro.2020.0129 -
Dysphagia Jun 2019Hyolaryngeal excursion (HE) is typically assessed via palpation during clinical swallowing exams (CSE) or visually during videofluoroscopy (VFSS). Minimal evidence... (Comparative Study)
Comparative Study
PURPOSE
Hyolaryngeal excursion (HE) is typically assessed via palpation during clinical swallowing exams (CSE) or visually during videofluoroscopy (VFSS). Minimal evidence exists to support the use of these perceptual methods for judging HE. We investigated whether binary judgment of HE differentiates quantitative measures of hyoid movement, using frame-by-frame VFSS analysis to measure anatomically scaled peak hyoid positions.
METHODS
Medical records of patients who received a CSE and VFSS within a 24-h period were reviewed. Clinician ratings of HE ('reduced' or 'normal') were collected from CSE and VFSS reports, along with rater experience. Five ml puree swallows were extracted from each VFSS for randomized, blinded analysis. Peak hyoid position from C4 was captured in anterior, superior, and hypotenuse positions and expressed relative to C2-C4 length. T-test comparisons of hyoid positions between patients judged to have reduced versus normal HE on palpation and VFSS were conducted.
RESULTS
Eighty-seven patients (56 male, mean age 61) met criteria. Peak anterior hyoid position was significantly different between patients judged to have reduced (mean = 89.2% C2-C4) and normal (mean = 110.6% C2-C4) HE on palpation (p = 0.001). Further analysis revealed no effect of clinician experience on differentiation of objective measures based on palpation. No differences were found across any objective measures when compared to clinician VFSS ratings.
CONCLUSIONS
Clinicians appeared to be able to differentiate peak anterior hyoid movement but not superior or hypotenuse movement on palpation. On VFSS visualization, no significant differences were found between swallows judged to have reduced versus normal HE in any directional dimension. While perceptual methods may contribute to clinical decision-making, clinicians should remain cautious when making judgments about HE using these methods.
Topics: Cineradiography; Clinical Decision-Making; Decision Support Techniques; Deglutition; Deglutition Disorders; Female; Humans; Hyoid Bone; Larynx; Male; Middle Aged; Movement; Observer Variation; Palpation; Point-of-Care Testing
PubMed: 30043080
DOI: 10.1007/s00455-018-9927-2 -
Cleveland Clinic Journal of Medicine Mar 2009The finding of a palpable breast mass on physical examination often warrants a radiologic workup including directed ultrasonography, diagnostic mammography, and, at... (Review)
Review
The finding of a palpable breast mass on physical examination often warrants a radiologic workup including directed ultrasonography, diagnostic mammography, and, at times, biopsy with ultrasonographic guidance. The choice of initial imaging study is most often guided by the patient's age at presentation. Communicating the clinical findings to both the patient and the radiologist helps ensure the selection of the most appropriate imaging studies and helps in the interpretation of those studies. Every woman with a palpable breast mass, regardless of her age, should undergo imaging to exclude or establish the diagnosis of cancer.
Topics: Breast Neoplasms; Diagnosis, Differential; Female; Humans; Mammography; Palpation; Reproducibility of Results
PubMed: 19258464
DOI: 10.3949/ccjm.76a.08015 -
Journal of Korean Medical Science Aug 2014
Topics: Bias; Early Detection of Cancer; Evidence-Based Medicine; Humans; Incidence; Palpation; Reproducibility of Results; Republic of Korea; Risk Factors; Sensitivity and Specificity; Survival Rate; Thyroid Neoplasms; Ultrasonography; Unnecessary Procedures
PubMed: 25120309
DOI: 10.3346/jkms.2014.29.8.1033