Reliability of Physical Signs in Patients with Severe Attacks of Ulcerative Colitis

Graham, N. G.; Dombal, F. T. de; Goligher, J. C.

doi:10.1136/bmj.2.5764.746

Cited by 24 publications

(5 citation statements)

References 14 publications

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“…REVERSIBLE CEREBRAL ISCHEMIA/Tomasello et al THE reported effects of dimethyl sulfoxide (DMSO) are protean and include the ability to impair platelet aggregation 1,2 and to reduce brain damage after occlusion of cerebral blood vessels perhaps by reducing cerebral edema.…”

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confidence: 99%

“…The relevance of disagreement between two observers in reporting physical signs has been previously stressed. [1][2][3][4] Since 1976, eight clinical centres in Italy have been cooperating in a study of patients with reversible cerebral ischemia. The quantity of inter-observer differences in collection of historical data and in recording of neurological signs was evaluated.…”

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confidence: 99%

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Assessment of inter-observer differences in the Italian multicenter study on reversible cerebral ischemia.

Tomasello¹,

Mariani

Fieschi

et al. 1982

Stroke

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SUMMARY A standardized protocol was used for duplicate examination by two neurologists of the clinical history and neurological signs in 55 patients with reversible cerebral ischemia. One trained examiner from each of eight clinical centres involved in the Italian Cooperative Study on reversible cerebral ischemia participated in this research. Duplicate examinations were compared in order to evaluate the percentage of agreement achieved in the responses. Several discrepancies relating to either historical data or neurological signs were detected. Possible causes of this disagreement are discussed. The inter-observer differences appear to be an important problem to be faced in cooperative studies on reversible ischemic attacks. The purpose of the study was to estimate these differences in the attempt to increase the degree of agreement by repeated training sessions and discussion between the different examiners. These efforts are needed to improve the quality of clinical investigations on reversible cerebral ischemia and to increase the validity of their results.Stroke, Vol 13, No 1, 1982 THE magnitude of inter-observer discrepancies has to be carefully evaluated in any clinical research, especially one performed by several cooperative centres. The relevance of disagreement between two observers in reporting physical signs has been previously stressed.

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confidence: 99%

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confidence: 99%

Assessment of inter-observer differences in the Italian multicenter study on reversible cerebral ischemia.

Tomasello¹,

Mariani

Fieschi

et al. 1982

Stroke

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“…Unfortunately, the critical endpoint of opioid-related changes in abdominal examination was not addressed adequately because the examinations conducted before and after administration of medication were performed by different physicians. It is well known that there is significant variation between different physicians' abdominal evaluations, even when assessments are conducted simultaneously 19,20 . Therefore, the most important information yielded by this study was that early analgesia is not associated with detrimental outcomes.…”

Section: Discussionmentioning

confidence: 99%

Effect on diagnostic efficiency of analgesia for undifferentiated abdominal pain

Thomas

Silen

2003

Journal of British Surgery

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Background: The question of whether it is safe to provide analgesia for patients with undifferentiated acute abdominal pain is marked by longstanding controversy over the possible masking of physical findings. The goal of this review is to assess the pertinent studies.Method: A Medline search was performed in April 2002, using the terms 'analgesia', 'abdominal pain', 'acute abdomen' and 'morphine'. Other articles were identified using the bibliographies of papers found through Medline. All articles reporting clinical trials of analgesia and its effects on diagnosis or physical examination were reviewed.Results: A total of eight trials (one reported only as an abstract) were identified. Because of significant disparity in trial design, no formal analysis such as meta-analysis was performed. However, detailed review of the trials revealed a striking consistency in results. In no study was there an association between analgesia and diagnostic impairment or dangerous masking of the findings of physical examination. Conclusion:The literature addressing early pain relief for abdominal pain is characterized by weaknesses, but there is a common theme suggesting that analgesia is safe. Pending further research, which should address some of the shortcomings of extant studies, a practice of judicious provision of analgesia appears safe, reasonable and in the best interests of patients in pain.

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“…In the case of IBO, problems in eliciting and recording reproducible data are severe. This applies to clinical symptoms and signs (7), physicians' estimates of patient progress (8), and calculation of various indices of severity and activity (9).…”

Section: Practical Problems Concerning Databasesmentioning

confidence: 99%

World Perspectives: The OMGE Database for Inflammatory Bowel Disease

Timothy

1993

Canadian Journal of Gastroenterology

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This paper discusses several aspects of the creation, establishment and maintenance of a multinational database conceming patients with inflammatory bowel disease (IBD). lhe discussion is based on experience gained with the World Organisation of Gastroentcrology (OMGE) Research Committee's multinational survey of patients with IBD, comprising (in 1992) 4612 cases entered from 50 centres in 27 countries. The purposes of such a database are described, as are a number of practical problems in its creation and maintenance, such as deciding upon a (minimum) dataset, measured to maximize objectivity, and other difficulties in implementation. Finally, the benefits of th is type of research are discussed-and illustrated by highlighting some of the recent findings from the OMGE Research Committee's survey.

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Reliability of Physical Signs in Patients with Severe Attacks of Ulcerative Colitis

Cited by 24 publications

References 14 publications

Assessment of inter-observer differences in the Italian multicenter study on reversible cerebral ischemia.

Assessment of inter-observer differences in the Italian multicenter study on reversible cerebral ischemia.

Effect on diagnostic efficiency of analgesia for undifferentiated abdominal pain

World Perspectives: The OMGE Database for Inflammatory Bowel Disease

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