Clinical history-taking and physical examination in medical practice in Africa: still relevant?

Oyedokun, Ayo; Rudan, Igor; Balogun, Olanrewaju Samuel

doi:10.3325/cmj.2016.57.605

Cited by 19 publications

(14 citation statements)

References 9 publications

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“…Yet, in the last few decades, physicians and physicians-in-training have become more reliant on objective and quantifiable measures including labs and imaging in achieving disease diagnoses. [12] , [13] Electronic medical records (EMRs) have encouraged this shift away from history and towards quantifiable testing readily offered and pursued via today's digitized health systems. Originally intended to improve medication safety and reduce health care costs, EMR implementation has been associated with several unpredictable adverse consequences, including overdependence on technology (Campbell 2006).…”

Section: Discussionmentioning

confidence: 99%

Value of medical history in ophthalmology: A study of diagnostic accuracy

Wang

Asanad

et al. 2018

Journal of Current Ophthalmology

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PurposeThis study aimed to demonstrate the value of the chief compliant and patient history to accurately diagnose patient pathology without requiring ocular examination or imaging in an outpatient neuro-ophthalmology clinic.MethodsWe prospectively evaluated 115 consecutive patients at our institution from January to April 2009. The attending neuro-ophthalmologist committed to a single most likely diagnosis while solely being exposed to patient demographic information (age, gender, race) and chief complaint, but was otherwise blinded to ocular examination or imaging. The validity of the initial diagnosis was assessed by further acquiring subjective and objective findings and the percentage of correct diagnoses was determined.ResultsPatient cases were categorized based on the neuro-ophthalmologic localization of the final diagnoses: afferent nervous system, central nervous system (CNS), efferent nervous system, orbital system, and pupillary system. Correct diagnoses by chief complaint and patient history were 84%, 100%, 86%, 80%, 50% and 100% for afferent, central, efferent, orbit, pupil, and other neuro-ophthalmic diseases, respectively. Over half the cases were correctly diagnosed by chief complaint alone, which improved to 88% when combined with the patient history.ConclusionsA simple combination of patient history and chief complaint predicts an overall diagnostic accuracy in approximately 90% of cases. Our study demonstrates the remarkable diagnostic value of patient history in neuro-ophthalmologic clinic practice.

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Section: Discussionmentioning

confidence: 99%

Value of medical history in ophthalmology: A study of diagnostic accuracy

Wang

Asanad

et al. 2018

Journal of Current Ophthalmology

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“…These unwise rampant usages of diagnostic tests create huge burden over a constrained economy ( 18 ). Oyedokun et al ( 19 ) has re-emphasised the role of clinical skills in medical practice and healthcare in Africa.…”

Section: Reasons and Results Of Poor Clinical Aptmentioning

confidence: 99%

Clinical Skill: The Ebbing Art of Medicine

Datta

2021

MJMS

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Clinical history taking and physical examination are the essence of clinical medicine. However, the glare of modern diagnostic tools and techniques has overshadowed these basic but indispensable steps of diagnosis. Deterioration of clinical skills is a burning issue in this era due to over-reliance on high-end technology. Poor clinical judgment not only leads to mismanagement but also results in over-utilisation of health care resources. Moreover, with lesser time at the bedside, the physician-patient relationship is also getting compromised.

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“…examinations have been widely expanded and applied in clinics, while physical examinations have been underemphasized in medical practice [23]. Many clinicians now have formed a habit of relying excessively on auxiliary examinations to give diagnostic and therapeutic advice [24]. For example, many members in WeChat groups often presented an X-ray image to obtain advice on diagnosis or treatment.…”

Section: Resultsmentioning

confidence: 99%

Observation and Analysis of Case Discussions Using WeChat Groups Among Orthopedists

Li¹,

Hu²,

Alkhatatbeh³

et al. 2020

Preprint

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Background: With the vigorous development of social media networks, an increasing number of orthopedists in China are taking part in case discussions using WeChat groups. The case discussion process using WeChat is quick, convenient and not limited by time or space, but this kind of case discussion is also chaotic and unconstrained. This study is aimed to observe and analyze the purpose, participation, case completeness, opinion consistency of orthopedic case discussions using WeChat groups.Methods: We collected data related to the case discussions of three orthopedic surgeons by taking screenshots of the chat records in the most-used WeChat groups from June to August 2019, and analyzed the purpose, participation, completeness and the opinion consistency between the majority of members and experts in related fields.Results: The common purposes of orthopedic case discussions were showing surgical results and obtaining treatment advice. The number of likes received for cases showing surgical results was significantly higher than those for cases requesting diagnostic advice and obtaining treatment advice. The complete and relatively complete cases attracted more participants and received more effective comments than the incomplete cases. The opinion consistency rate of the complete cases was higher than that of the relatively complete and incomplete cases.Conclusions: The case discussions using WeChat groups among orthopedists was mainly to show surgical results and request for diagnostic advice. Incomplete cases had low discussion participation and low opinion consistency. Online discussions using WeChat groups should be standardized with respect to the completeness of cases.

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Clinical history-taking and physical examination in medical practice in Africa: still relevant?

Cited by 19 publications

References 9 publications

Value of medical history in ophthalmology: A study of diagnostic accuracy

Value of medical history in ophthalmology: A study of diagnostic accuracy

Clinical Skill: The Ebbing Art of Medicine

Observation and Analysis of Case Discussions Using WeChat Groups Among Orthopedists

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