Patient history and physical examination, traditionally the cornerstone diagnostic tool for medical care, may still be among the most accurate and cost-efficient methods to assess patients with congestive heart failure, UT Southwestern Medical Center researchers have found.
Such time-honored techniques have diminished in importance in recent years as doctors have come to rely on high-tech diagnostic approaches, such as imaging and measuring biomarkers.
In today's issue of Circulation: Heart Failure, however, UT Southwestern and other researchers have found that the history and physical exam are still viable. History and physical examinations were performed for 388 patients enrolled in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial, and their findings were recorded on a standardized form. About half of these patients also underwent an invasive right-heart catheterization to measure how much fluid they had in their body.
Researchers found that the estimates of the amount of fluid from the history and physical exam compared favorably to the results of the invasive measurements.
Additionally, patients who were estimated to have extra fluid through the collection of histories and physical exams were found to be at increased risk of being hospitalized or dying over the next six months.
"Our study touches upon an important clinical question: If physicians were more adept at performing histories and physicals, would they rely less on more costly diagnostic tests?" said Dr. Drazner.
"Hopefully, this study might shift the pendulum back just a bit towards using the history and physical examination in patient care. It might even get trainees more interested in learning about the history and physical examination so that this important art can be perpetuated in future generations of physicians."
Source: UT Southwestern Medical Center
Related stories:
Stephen Hawking named to Canada's Perimeter Institute
Famed physicist Stephen Hawking has been appointed to the position of distinguished research chair at Canada's leading scientific brain trust, the Perimeter Institute for Theoretical Physics announced Thursday.
Obesity, other health problems delay MS diagnosis
People with pre-existing medical conditions, such as obesity, and vascular problems such as diabetes, high blood pressure or high cholesterol, may experience a delay in being diagnosed with multiple sclerosis (MS), or experience an increase in severity of the disease at diagnosis, according to a study published in the October 29, 2008, online issue of
Neurology, the medical journal of the American Academy of Neurology.
Racial disparities in cardiovascular health linked to birth weight, slavery
Two new articles examine the theory of "fetal programming" and their effect on racial health disparities. The studies, published in
American Journal of Human Biology, suggest that the higher rates of hypertension and cardiovascular disease present in African Americans may be a consequence of low birth weights, and that these low birth weights may be a result of social rather than genetic factors.
Study shows high risk women can take control of diabetes 'destiny'
(PhysOrg.com) -- Women at high risk of diabetes can reduce their body’s ‘insulin resistance’ – the most important biological risk factor for diabetes – by exercising, a British Heart Foundation study from the University of Glasgow indicates today.
A healthy lifestyle halves the risk of premature death in women
Over half of deaths in women from chronic diseases such as cancer and heart disease could be avoided if they never smoke, keep their weight in check, take exercise and eat a healthy diet low in red meat and trans-fats, according to a study published on bmj.com today.
Mayo Clinic chest surgeons propose measures for indicating quality of lung surgery
Even though 30,000 patients in the United States undergo lung surgery each year, no standard criteria exist to measure the quality of their care. In the current issue of
The Annals of Thoracic Surgery, Mayo Clinic surgeons have proposed a system of lung surgery quality indicators for surgeons and the public as a method to demonstrate best practices for obtaining positive patient outcomes.
Positive exercise testing in athletes: What does that mean?
Sudden cardiac death (SCD) during sports activity is an uncommon, but catastrophic event. Different efforts to reduce the risk of SCD related to sports have been undertaken. What is the role of the exercise test in this context? What does a positive exercise test mean?
Low vitamin D levels pose large threat to health
Researchers at Johns Hopkins are reporting what is believed to be the most conclusive evidence to date that inadequate levels of vitamin D, obtained from milk, fortified cereals and exposure to sunlight, lead to substantially increased risk of death.