Reengineering the Physical Examination for the New Millennium?

Nelson, William G.; Rosen, Antony; Pronovost, Peter J.

doi:10.1001/jama.2016.4470

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…Therefore, alternatives such as chest X-ray and lung ultrasound should be explored. Several studies have shown that lung ultrasound has greater sensitivity than chest X-ray [13] and has a good correlation with chest CT [5,14].…”

Section: Discussionmentioning

confidence: 99%

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Usefulness of Multi-Organ Point-of-Care Ultrasound as a Complement to the Decision-Making Process in Internal Medicine

Casado-López¹,

Tung‐Chen²,

Torres-Arrese³

et al. 2022

JCM

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Accumulated data show the utility of diagnostic multi-organ point-of-care ultrasound (PoCUS) in the assessment of patients admitted to an internal medicine ward. We assessed whether multi-organ PoCUS (lung, cardiac, and abdomen) provides relevant diagnostic and/or therapeutic information in patients admitted for any reason to an internal medicine ward. We conducted a prospective, observational, and single-center study, at a secondary hospital. Multi-organ PoCUS was performed during the first 24 h of admission. The sonographer had access to the patients’ medical history, physical examination, and basic complementary tests performed in the Emergency Department (laboratory, X-ray, electrocardiogram). We considered a relevant ultrasound finding if it implied a significant diagnostic and/or therapeutic change. In the second semester of 2019, we enrolled 310 patients, 48.7% were male and the mean age was 70.5 years. Relevant ultrasound findings were detected in 86 patients (27.7%) and in 60 (19.3%) triggered a therapeutic change. These findings were associated with an older age (Mantel–Haenszel χ2 = 25.6; p < 0.001) and higher degree of dependency (Mantel–Haenszel χ2 = 5.7; p = 0.017). Multi-organ PoCUS provides relevant diagnostic information, complementing traditional physical examination, and facilitates therapy adjustment, regardless of the cause of admission. Multi-organ PoCUS to be useful need to be systematically integrated into the decision-making process in internal medicine.

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Section: Discussionmentioning

confidence: 99%

“…It seems evident that PoCUS can revolutionize the way of examining patients since it complements and enhances traditional physical examination. Thus, together with inspection, palpation, percussion, and auscultation, it can become the fifth pillar of the physical examination [5,6].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Multi-Organ Point-of-Care Ultrasound as a Complement to the Decision-Making Process in Internal Medicine

Casado-López¹,

Tung‐Chen²,

Torres-Arrese³

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…The traditional paradigm for medical diagnostics, which is still actively practised around the globe, relies on physicians’ use of their five basic senses to make inferences about a patient’s health 1 . For example, palpation through orifices such as the oral cavity, rectum or vaginal canal is still the predominant diagnostic mechanism within the digestive and female reproductive tracts 2 . Although inexpensive and straightforward, such subjective methods are prone to error and bias 2 .…”

Section: Introductionmentioning

confidence: 99%

“…For example, palpation through orifices such as the oral cavity, rectum or vaginal canal is still the predominant diagnostic mechanism within the digestive and female reproductive tracts 2 . Although inexpensive and straightforward, such subjective methods are prone to error and bias 2 . A growing trend is to replace physicians’ own senses with electronic sensors, which not only enhances the range and quality of detection but also provides a means of establishing ‘ground truths’ for pathological conditions based on the collection of large clinically acquired datasets 3 .…”

Section: Introductionmentioning

confidence: 99%

Mucosa-interfacing electronics

et al. 2022

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The surface mucosa that lines many of our organs houses myriad biometric signals and, therefore, has great potential as a sensor–tissue interface for high-fidelity and long-term biosensing. However, progress is still nascent for mucosa-interfacing electronics owing to challenges with establishing robust sensor–tissue interfaces; device localization, retention and removal; and power and data transfer. This is in sharp contrast to the rapidly advancing field of skin-interfacing electronics, which are replacing traditional hospital visits with minimally invasive, real-time, continuous and untethered biosensing. This Review aims to bridge the gap between skin-interfacing electronics and mucosa-interfacing electronics systems through a comparison of the properties and functions of the skin and internal mucosal surfaces. The major physiological signals accessible through mucosa-lined organs are surveyed and design considerations for the next generation of mucosa-interfacing electronics are outlined based on state-of-the-art developments in bio-integrated electronics. With this Review, we aim to inspire hardware solutions that can serve as a foundation for developing personalized biosensing from the mucosa, a relatively uncharted field with great scientific and clinical potential.

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Section: Introductionmentioning

confidence: 99%

Usefulness of Multi-Organ Point-Of-Care Ultrasound as a Complement to the Decision-Making Process in Internal Medicine

Casado-López¹,

Tung‐Chen²,

Torres-Arrese³

et al. 2022

Preprint

View full text Add to dashboard Cite

Accumulated data show the utility of diagnostic multi-organ point-of-care ultrasound (PoCUS) in the assessment of patients admitted to an internal medicine ward. Assess whether multi-organ PoCUS (lung, cardiac, and abdomen) provides relevant diagnostic and/or therapeutic information in patients admitted for any reason to an internal medicine ward. Prospective, observational, and single-center study, at a secondary hospital. Multi-organ PoCUS was performed during the first 24 hours of admission. The sonographer had access to the patients’ medical history, physical examination, and basic complementary tests performed in the ED (laboratory, X-ray, electrocardiogram). We considered a relevant ultrasound finding if it implied a significant diagnostic and/or therapeutic change. In the second semester of 2019, 310 patients were enrolled (48.7% men, mean age 70.5 years). Relevant ultrasound findings were detected in 86 patients (27.7%) and in 60 (19.3%) triggered a therapeutic change. These findings were associated with older age (Mantel-Haenszel 2 = 25.6; p&lt; .001) and higher degree of dependency (Mantel Haenszel 2 = 5.7; p = .017). Multi-organ PoCUS provides relevant diagnostic information, complementing traditional physical exam, and facilitates therapy adjustment, regardless of the cause of admission. Multi-organ PoCUS to be useful need to be systematically integrated into the decision-making process in internal medicine.

show abstract

Reengineering the Physical Examination for the New Millennium?

Cited by 5 publications

References 8 publications

Usefulness of Multi-Organ Point-of-Care Ultrasound as a Complement to the Decision-Making Process in Internal Medicine

Usefulness of Multi-Organ Point-of-Care Ultrasound as a Complement to the Decision-Making Process in Internal Medicine

Mucosa-interfacing electronics

Usefulness of Multi-Organ Point-Of-Care Ultrasound as a Complement to the Decision-Making Process in Internal Medicine

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