Diagnostic value of the physical examination in patients with dyspnea

Abstract

We reviewed the evidence for the diagnostic accuracy of the physical examination in diagnosing pneumonia, pleural effusion, chronic obstructive pulmonary disease, and congestive heart failure in patients with dyspnea and found that the physical examination has reliable diagnostic accuracy for these common conditions.

Physical signs in patients with chronic obstructive pulmonary disease

“…[85] The positive LR of early inspiratory crackles is 14.6. [868788] The positive LR for detecting severe chronic airflow obstruction is 20.8. [85]…”

Access, Equity, and Neutral Space: Telehealth Beyond the Pandemic

“…Evaluation of dyspnea, for example, has been found to benefit significantly from a physical exam. 12 Home blood pressure monitoring, on the other hand, has repeatedly demonstrated greater accuracy and prognostic value than in-clinic readings, especially when a medical professional observes and provides feedback on patients' self-measurement technique over video. 13 With this variation in mind, "hybrid practices," which provide a combination of in-person and telehealth visits, offer a promising compromise.…”

Ensino do exame respiratório: o que é história e o que é necessidade?

“…Nos casos em que houve redução do FTV, pôde-se inferir o diagnóstico de derrame pleural com razão de verossimilhança positiva de 5,7 e razão de verossimilhança negativa de 0,21. De acordo com os autores, a diminuição do FTV reforçaria a hipótese de derrame pleural em aproximadamente 30-35% e, nos casos de pacientes com dispneia que cursam com aumento do FTV ou FTV normal, a probabilidade de diagnosticar derrame pleural reduziria em aproximadamente 30%, direcionando a hipótese diagnóstica para pneumonia 21 . Outra revisão sugere que a palpação do FTV pode auxiliar em casos em que a probabilidade pré-teste de derrame pleural seja baixa.…”