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Brazilian Journal of Physical Therapy 2020Differential diagnosis is a systematic process used to identify the proper diagnosis from a set of possible competing diagnoses. (Review)
Review
BACKGROUND
Differential diagnosis is a systematic process used to identify the proper diagnosis from a set of possible competing diagnoses.
METHODS
The goal of this masterclass is to discuss the higher order thinking components of differential diagnosis.
CONCLUSIONS
For healthcare providers, diagnosis is one of many necessary components during the clinical decision making process and it is hallmarked by differentiation of competing structures for a definitive understanding of the underlying condition. The diagnostic process involves identifying or determining the etiology of a disease or condition through evaluation of patient history, physical examination, and review of laboratory data or diagnostic imaging; and the subsequent descriptive title of that finding. Whereas differential diagnosis is a varied skill set among all healthcare providers, the concept of a diagnosis is equally germane, regardless of one's background. In theory, a diagnosis improves the use of classification tools, improves clarity and communication, provides a trajectory of treatment, improves understanding of a person's prognosis, and in some cases, may be useful for preventative treatments. To achieve these improvements, one must have an understanding of relation of the clinical utility of tests and measures with diagnosis, and how to best implement these findings in clinical practice. This requires a deeper understanding (higher order thinking) of the role of diagnosis in the management of patients.
Topics: Diagnosis, Differential; Humans; Physical Examination; Prognosis
PubMed: 30723033
DOI: 10.1016/j.bjpt.2019.01.010 -
Journal of Graduate Medical Education Aug 2019
Topics: Female; Humans; Internship and Residency; Male; Physical Examination; Students, Medical
PubMed: 31440347
DOI: 10.4300/JGME-D-18-01063.1 -
CA: a Cancer Journal For Clinicians May 2016Answer questions and earn CME/CNE Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision making about cancer treatment... (Review)
Review
Answer questions and earn CME/CNE Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision making about cancer treatment and risk-reduction options. Physical examination of the female cancer patient with sexual concerns, regardless of the type or site of her cancer, is an essential and early component of a comprehensive evaluation and effective treatment plan. Specialized practices are emerging that focus specifically on evaluation and treatment of women with cancer and sexual function problems. As part of a specialized evaluation, oncologists and their patients should expect a thorough physical examination to identify or rule out physical causes of sexual problems or dysfunction. This review provides oncology professionals with a description of the physical examination of the female cancer patient with sexual function concerns. This description aims to inform anticipatory guidance for the patient and to assist in interpreting specialists' findings and recommendations. In centers or regions where specialized care is not yet available, this review can also be used by oncology practices to educate and support health care providers interested in expanding their practices to treat women with cancer and sexual function concerns. CA Cancer J Clin 2016;66:241-263. © 2016 American Cancer Society.
Topics: Female; Gynecological Examination; Gynecology; Humans; Neoplasms; Oncologists; Physical Examination; Referral and Consultation; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Survival Rate
PubMed: 26784536
DOI: 10.3322/caac.21337 -
Neurology India 2020The actual investigation of the body of a patient by the clinician in search for the signs of the disease beginning with the primary vital signs and continues with the... (Review)
Review
The actual investigation of the body of a patient by the clinician in search for the signs of the disease beginning with the primary vital signs and continues with the careful and attentive observation of the patient. This article reviews the key findings in the physical examination of patients with ischemic stroke that have the potential to indicate the etiology of the infarct and to help to choose the use of ancillary tests. Through a systematic search of articles published in English related to the physical examination of patients with stroke, we identified key findings in the vital signs and classic components of the physical exam (appearance of the patient, auscultation, and eye examination) that have shown clinical significance when determining ischemic stroke etiology. We further suggest that the prompt identification of such findings can translate into better use of diagnostic tools and selection of ancillary confirmatory tests, thus, reducing the time to etiology based treatment and secondary prevention of ischemic stroke. in this manuscript, we aim to show that even though nowadays the clinical skills tend to be overlooked due to the overreliance on technology, the physical exam continues to be a valuable tool in the clinician armamentarium when facing the challenge of a patient with ischemic stroke.
Topics: Auscultation; Heart Auscultation; Humans; Ischemic Stroke; Neck; Ophthalmoscopy; Physical Examination; Secondary Prevention; Vital Signs
PubMed: 32415006
DOI: 10.4103/0028-3886.284386 -
BMC Oral Health Jun 2023Myofunctional orofacial examination (MOE) is an important tool for the assessment of the stomatognathic system and orofacial functions, and the early diagnosis of... (Review)
Review
INTRODUCTION
Myofunctional orofacial examination (MOE) is an important tool for the assessment of the stomatognathic system and orofacial functions, and the early diagnosis of orofacial myofunctional disorders. Therefore, the purpose of the study is to scan the literature and determine the most preferred test for myofunctional orofacial examination.
MATERIALS AND METHODS
A literature review was conducted to collect information. Pubmed and ScienceDirect database was explored by using keywords gained by MeSH (Medical Subject Headings).
RESULTS
Fifty-six studies were retrived from the search and all of the studies were screened and evaluated regarding the subject, aim, conclusions and the orofacial myofunctional examination test they used. It has been observed that traditional evaluation and inspection methods have been replaced by newer and methodological approaches in recent years.
CONCLUSIONS
Although the few tests used differ, 'Orofacial Examination Test With Scores' (OMES) was found to be the most preferred myofunctional orofacial evaluation method from ENT to cardiology.
Topics: Humans; Reproducibility of Results; Physical Examination; Mouth; Face
PubMed: 37268963
DOI: 10.1186/s12903-023-03056-1 -
MedEdPORTAL : the Journal of Teaching... 2022Physicians need adequate physical exam skills. Unfortunately, interns have variable physical exam skills, and teaching is often limited to rounds, an inconsistent...
INTRODUCTION
Physicians need adequate physical exam skills. Unfortunately, interns have variable physical exam skills, and teaching is often limited to rounds, an inconsistent setting. Physical exam skills, particularly those involving auscultation, require practice. Our goal was to create a cardiac physical exam workshop for pediatric interns that would improve their performance on an interactive assessment of their ability and understanding in physical exam and murmur interpretation.
METHODS
We completed a targeted needs assessment and then developed a 2-hour workshop on the pediatric cardiac physical exam targeted to pediatrics residents. The workshop included didactics, group discussion, and practice interpreting common pediatric murmurs. Pediatrics residents completed the assessment as a pretest and then participated in the workshop. At the end of the workshop, the assessment was administered as a posttest, followed by a reassessment 3 months later. Nonparametric statistical analysis was conducted. Pre- and posttest scores were compared using the Wilcoxon signed rank test.
RESULTS
Twenty-five residents completed the workshop, including 22 pediatrics residents, one pediatrics/anesthesia combined resident, one pediatric neurology resident, and one resident completing a preliminary year in pediatrics prior to dermatology residency. There was a significant increase in the mean score on the assessment from pre- to posttest (pretest = 54%, posttest = 71%, < .001). This increase was sustained at the 3-month reassessment ( = 67%).
DISCUSSION
This cardiac physical exam workshop demonstrated improvement in physical exam knowledge and interpretation ability as measured by an online pre-/posttest.
Topics: Child; Humans; Internship and Residency; Clinical Competence; Physical Examination; Heart Murmurs; Auscultation
PubMed: 36605544
DOI: 10.15766/mep_2374-8265.11289 -
The Medical Journal of Malaysia Sep 2022Physical examination (PE) techniques used in medical schools appear redundant in several aspects: unnecessarily regimental, lacking in efficiency, and lengthy. Many...
Physical examination (PE) techniques used in medical schools appear redundant in several aspects: unnecessarily regimental, lacking in efficiency, and lengthy. Many techniques are sustained solely because of the age-old tradition. This commentary suggests a simplification of PE techniques to make them acceptable to all the stakeholders, such as patients, medical students, and medical teachers. This is especially relevant in this era when imaging is widely used for diagnosis, and the confidence and reliance on PE are declining. Opinions of 10 senior consultants active in medical practice, teaching, and assessment were sought to know their concurrence with the authors' views. Seven of them provided their opinions, which showed considerable agreement with the authors' views regarding PE. All the items presented in this paper are mostly supported by the opinions of the senior consultants, textbooks, and literature. We consider sharing this work with the fraternity worthwhile.
Topics: Humans; Medicine; Physical Examination; Schools, Medical; Students, Medical
PubMed: 36169079
DOI: No ID Found -
Fertility and Sterility Sep 2020
Topics: Andrology; Diagnosis, Differential; Humans; Male; Office Visits; Palpation; Physical Examination; Predictive Value of Tests; Telemedicine
PubMed: 32859374
DOI: 10.1016/j.fertnstert.2020.07.009 -
Deutsches Arzteblatt International Jan 2015
Topics: Cardiovascular Diseases; Humans; Medical History Taking; Physical Examination; Postoperative Complications; Preoperative Care
PubMed: 25686386
DOI: 10.3238/arztebl.2015.0070a -
The American Journal of Medicine Mar 2021
Topics: COVID-19; Echocardiography; Health Services Needs and Demand; Heart Auscultation; Humans; Infection Control; Patient Care Management; Physical Examination; Point-of-Care Testing; SARS-CoV-2
PubMed: 33220283
DOI: 10.1016/j.amjmed.2020.10.026