keyword
Keywords "the rational clinical examina...

"the rational clinical examination"

https://read.qxmd.com/read/36976276/does-this-child-with-high-blood-pressure-have-secondary-hypertension-the-rational-clinical-examination-systematic-review
#1
COMPARATIVE STUDY
James T Nugent, Kuan Jiang, Melissa C Funaro, Ishan Saran, Chelsea Young, Lama Ghazi, Christine Y Bakhoum, F Perry Wilson, Jason H Greenberg
IMPORTANCE: Guidelines recommend that all children and adolescents with hypertension undergo evaluation for secondary causes. Identifying clinical factors associated with secondary hypertension may decrease unnecessary testing for those with primary hypertension. OBJECTIVE: To determine the utility of the clinical history, physical examination, and 24-hour ambulatory blood pressure monitoring for differentiating primary hypertension from secondary hypertension in children and adolescents (aged ≤21 years)...
March 28, 2023: JAMA
https://read.qxmd.com/read/35699701/does-this-patient-with-acute-infectious-conjunctivitis-have-a-bacterial-infection-the-rational-clinical-examination-systematic-review
#2
JOURNAL ARTICLE
Davin Johnson, Daisy Liu, David Simel
IMPORTANCE: Acute infectious conjunctivitis is characterized by ocular redness and discharge, and is a common clinical entity. Evidence-based tools to aid the clinical diagnosis of viral vs bacterial conjunctivitis are lacking and may contribute to overprescribing of topical antibiotics. OBJECTIVE: To determine the relative prevalence of viral vs bacterial conjunctivitis in adults and children, and to determine which symptoms or signs are suggestive of a viral vs bacterial etiology...
June 14, 2022: JAMA
https://read.qxmd.com/read/34313682/does-this-adult-patient-have-hypertension-the-rational-clinical-examination-systematic-review
#3
JOURNAL ARTICLE
Anthony J Viera, Yuichiro Yano, Feng-Chang Lin, David L Simel, Jonathan Yun, Gaurav Dave, Ann Von Holle, Laura A Viera, Daichi Shimbo, Shakia T Hardy, Katrina E Donahue, Alan Hinderliter, Christiane E Voisin, Daniel E Jonas
Importance: Office blood pressure (BP) measurements are not the most accurate method to diagnose hypertension. Home BP monitoring (HBPM) and 24-hour ambulatory BP monitoring (ABPM) are out-of-office alternatives, and ABPM is considered the reference standard for BP assessment. Objective: To systematically review the accuracy of oscillometric office and home BP measurement methods for correctly classifying adults as having hypertension, defined using ABPM. Data Sources: PubMed, Cochrane Library, Embase, ClinicalTrials...
July 27, 2021: JAMA
https://read.qxmd.com/read/33120444/-medical-imaging-clinical-appropriateness-rational-examination-according-to-evidence-based-medical-imaging
#4
JOURNAL ARTICLE
H Lyu, Z C Wang, X Q Liu, Y Y Kong, N Zeng, M Y Li, P F Zhao, H You, Z H Yang, Z T Zhang
The rational clinical examination is important. The authors raised the concept of "medical imaging clinical appropriateness (MICA) " to meet the medical need in clinic (for diagnosis or assessment of a kind of disease or syndrome), which means radiologists and clinicians work together to carefully evaluate the necessity and rationality of an examination according to evidence of evidence-based medicine, expertise, experience, and patient's willing.The necessity is prerequisite, the rationality is the core, the evaluation of evidence is the basis, the application of evidence-based medicine is the important method...
November 1, 2020: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://read.qxmd.com/read/31846019/does-this-patient-have-hip-osteoarthritis-the-rational-clinical-examination-systematic-review
#5
JOURNAL ARTICLE
David Metcalfe, Daniel C Perry, Henry A Claireaux, David L Simel, Cheryl K Zogg, Matthew L Costa
IMPORTANCE: Hip osteoarthritis (OA) is a common cause of pain and disability. OBJECTIVE: To identify the clinical findings that are most strongly associated with hip OA. DATA SOURCES: Systematic search of MEDLINE, PubMed, EMBASE, and CINAHL from inception until November 2019. STUDY SELECTION: Included studies (1) quantified the accuracy of clinical findings (history, physical examination, or simple tests) and (2) used plain radiographs as the reference standard for diagnosing hip OA...
December 17, 2019: JAMA
https://read.qxmd.com/read/31237649/did-this-patient-have-cardiac-syncope-the-rational-clinical-examination-systematic-review
#6
JOURNAL ARTICLE
Omar T Albassam, Robert J Redelmeier, Steven Shadowitz, Aatif M Husain, David Simel, Edward E Etchells
IMPORTANCE: Syncope can result from a reduction in cardiac output from serious cardiac conditions, such as arrhythmias or structural heart disease (cardiac syncope), or other causes, such as vasovagal syncope or orthostatic hypotension. OBJECTIVE: To perform a systematic review of studies of the accuracy of the clinical examination for identifying patients with cardiac syncope. STUDY SELECTION: Studies of adults presenting to primary care, emergency departments, or referred to specialty clinics...
June 25, 2019: JAMA
https://read.qxmd.com/read/30758508/does-this-patient-have-a-severe-snake-envenomation-the-rational-clinical-examination-systematic-review
#7
JOURNAL ARTICLE
Charles J Gerardo, João R N Vissoci, C Scott Evans, David L Simel, Eric J Lavonas
IMPORTANCE: Venomous snakebite severity ranges from an asymptomatic dry bite to severe envenomation and death. The clinical evaluation aids in prognosis and is essential to determine the risks and potential benefits of antivenom treatment. OBJECTIVES: To identify historical features, clinical examination findings, basic laboratory testing, and clinical grading scales that will risk-stratify patients with pit viper snake envenomation for severe systemic envenomation, severe tissue injury, and/or severe hematologic venom effects...
April 1, 2019: JAMA Surgery
https://read.qxmd.com/read/30721300/will-this-patient-be-difficult-to-intubate-the-rational-clinical-examination-systematic-review
#8
JOURNAL ARTICLE
Michael E Detsky, Naheed Jivraj, Neill K Adhikari, Jan O Friedrich, Ruxandra Pinto, David L Simel, Duminda N Wijeysundera, Damon C Scales
IMPORTANCE: Recognizing patients in whom endotracheal intubation is likely to be difficult can help alert physicians to the need for assistance from a clinician with airway training and having advanced airway management equipment available. OBJECTIVE: To identify risk factors and physical findings that predict difficult intubation. DATA SOURCES: The databases of MEDLINE and EMBASE were searched from 1946 to June 2018 and from 1947 to June 2018, respectively, and the reference lists from the retrieved articles and previous reviews were searched for additional studies...
February 5, 2019: JAMA
https://read.qxmd.com/read/30167704/will-this-hospitalized-patient-develop-severe-alcohol-withdrawal-syndrome-the-rational-clinical-examination-systematic-review
#9
REVIEW
Evan Wood, Loai Albarqouni, Stacey Tkachuk, Carolyn J Green, Keith Ahamad, Seonaid Nolan, Mark McLean, Jan Klimas
IMPORTANCE: Although severe alcohol withdrawal syndrome (SAWS) is associated with substantial morbidity and mortality, most at-risk patients will not develop this syndrome. Predicting its occurrence is important because the mortality rate is high when untreated. OBJECTIVE: To assess the accuracy and predictive value of symptoms and signs for identifying hospitalized patients at risk of SAWS, defined as delirium tremens, withdrawal seizure, or clinically diagnosed severe withdrawal...
August 28, 2018: JAMA
https://read.qxmd.com/read/29136449/does-this-patient-have-acute-mountain-sickness-the-rational-clinical-examination-systematic-review
#10
REVIEW
David Meier, Tinh-Hai Collet, Isabella Locatelli, Jacques Cornuz, Bengt Kayser, David L Simel, Claudio Sartori
Importance: Acute mountain sickness (AMS) affects more than 25% of individuals ascending to 3500 m (11 500 ft) and more than 50% of those above 6000 m (19 700 ft). AMS may progress from nonspecific symptoms to life-threatening high-altitude cerebral edema in less than 1% of patients. It is not clear how to best diagnose AMS. Objective: To systematically review studies assessing the accuracy of AMS diagnostic instruments, including the visual analog scale (VAS) score, which quantifies the overall feeling of sickness at altitude (VAS[O]; various thresholds), Acute Mountain Sickness-Cerebral score (AMS-C; ≥0...
November 14, 2017: JAMA
https://read.qxmd.com/read/28763554/does-this-child-have-pneumonia-the-rational-clinical-examination-systematic-review
#11
REVIEW
Sonal N Shah, Richard G Bachur, David L Simel, Mark I Neuman
IMPORTANCE: Pneumonia is a leading cause of morbidity and mortality in children. It is important to identify the clinical symptoms and physical examination findings associated with pneumonia to improve timely diagnosis, prevent significant morbidity, and limit antibiotic overuse. OBJECTIVE: To systematically review the accuracy of symptoms and physical examination findings in identifying children with radiographic pneumonia. DATA SOURCES AND STUDY SELECTION: MEDLINE and Embase (1956 to May 2017) were searched, along with reference lists from retrieved articles, to identify diagnostic studies of pediatric pneumonia across a broad age range that had to include children younger than age 5 years (although some studies enrolled children up to age 19 years); 3644 unique articles were identified, of which 23 met inclusion criteria...
August 1, 2017: JAMA
https://read.qxmd.com/read/27115266/does-this-patient-have-infectious-mononucleosis-the-rational-clinical-examination-systematic-review
#12
REVIEW
Mark H Ebell, Marlene Call, JoAnna Shinholser, Jack Gardner
IMPORTANCE: Early, accurate diagnosis of infectious mononucleosis can help clinicians target treatment, avoid antibiotics, and provide an accurate prognosis. OBJECTIVE: To systematically review the literature regarding the value of the clinical examination and white blood cell count for the diagnosis of mononucleosis. DATA SOURCES: The databases of PubMed (from 1966-2016) and EMBASE (from 1947-2015) were searched and a total of 670 articles and abstracts were reviewed for eligibility...
April 12, 2016: JAMA
https://read.qxmd.com/read/26717031/will-neuroimaging-reveal-a-severe-intracranial-injury-in-this-adult-with-minor-head-trauma-the-rational-clinical-examination-systematic-review
#13
REVIEW
Joshua S Easter, Jason S Haukoos, William P Meehan, Victor Novack, Jonathan A Edlow
IMPORTANCE: Adults with apparently minor head trauma (Glasgow Coma Scale [GCS] scores ≥13 who appear well on examination) may have severe intracranial injuries requiring prompt intervention. Findings from clinical examination can aid in determining which adults with minor trauma have severe intracranial injuries visible on computed tomography (CT). OBJECTIVE: To assess systematically the accuracy of symptoms and signs in adults with minor head trauma in order to identify those with severe intracranial injuries...
December 22, 2015: JAMA
https://read.qxmd.com/read/26547467/does-this-patient-with-chest-pain-have-acute-coronary-syndrome-the-rational-clinical-examination-systematic-review
#14
REVIEW
Alexander C Fanaroff, Jennifer A Rymer, Sarah A Goldstein, David L Simel, L Kristin Newby
IMPORTANCE: About 10% of patients with acute chest pain are ultimately diagnosed with acute coronary syndrome (ACS). Early, accurate estimation of the probability of ACS in these patients using the clinical examination could prevent many hospital admissions among low-risk patients and ensure that high-risk patients are promptly treated. OBJECTIVE: To review systematically the accuracy of the initial history, physical examination, electrocardiogram, and risk scores incorporating these elements with the first cardiac-specific troponin...
November 10, 2015: JAMA
https://read.qxmd.com/read/25523678/re-does-this-man-with-lower-urinary-tract-symptoms-have-bladder-outlet-obstruction-the-rational-clinical-examination-a-systematic-review
#15
EDITORIAL
Steven A Kaplan
No abstract text is available yet for this article.
January 2015: Journal of Urology
https://read.qxmd.com/read/25096693/does-this-man-with-lower-urinary-tract-symptoms-have-bladder-outlet-obstruction-the-rational-clinical-examination-a-systematic-review
#16
REVIEW
Karen A D'Silva, Philipp Dahm, Camilla L Wong
IMPORTANCE: Early, accurate diagnosis of bladder outlet obstruction in men with lower urinary tract symptoms may reduce the need for invasive testing (ie, catheter placement, urodynamics), and prompt early treatment to provide symptomatic relief and avoid complications. OBJECTIVES: To systematically review the evidence on (1) the diagnostic accuracy of office-based tests for bladder outlet obstruction in men with lower urinary tract symptoms; and (2) the accuracy of the bladder scan as a measure of urine volume because management decisions rely on measuring postvoid bladder residual volumes...
August 6, 2014: JAMA
https://read.qxmd.com/read/25058220/does-this-patient-have-generalized-anxiety-or-panic-disorder-the-rational-clinical-examination-systematic-review
#17
REVIEW
Nathaniel R Herr, John W Williams, Sophiya Benjamin, Jennifer McDuffie
IMPORTANCE: In primary care settings, generalized anxiety disorder (GAD) and panic disorder are common but underrecognized illnesses. Identifying accurate and feasible screening instruments for GAD and panic disorder has the potential to improve detection and facilitate treatment. OBJECTIVE: To systematically review the accuracy of self-report screening instruments in diagnosing GAD and panic disorder in adults. DATA SOURCES: We searched MEDLINE, PsycINFO, and the Cochrane Library for relevant articles published from 1980 through April 2014...
July 2, 2014: JAMA
https://read.qxmd.com/read/25027143/does-this-adult-patient-have-early-hiv-infection-the-rational-clinical-examination-systematic-review
#18
REVIEW
Evan Wood, Thomas Kerr, Greg Rowell, Julio S G Montaner, Peter Phillips, P Todd Korthuis, David L Simel
IMPORTANCE: Timely identification of human immunodeficiency virus (HIV) infection in adults can contribute to reduced mortality and likelihood of further HIV transmission. During the first 6 months after infection, known as early HIV infection, patients often report a well-described constellation of symptoms and signs. However, the literature examining utility of the clinical examination in identifying early infection has not been systematically assessed. OBJECTIVE: To assess the accuracy of symptoms and signs in identifying early HIV infection among adults...
July 16, 2014: JAMA
https://read.qxmd.com/read/24938565/does-this-patient-have-an-exudative-pleural-effusion-the-rational-clinical-examination-systematic-review
#19
REVIEW
M Elizabeth Wilcox, Christopher A K Y Chong, Matthew B Stanbrook, Andrea C Tricco, Camilla Wong, Sharon E Straus
IMPORTANCE: Thoracentesis is performed to identify the cause of a pleural effusion. Although generally safe, thoracentesis may be complicated by transient hypoxemia, bleeding, patient discomfort, reexpansion pulmonary edema, and pneumothorax. OBJECTIVE: To identify the best means for differentiating between transudative and exudative effusions and also to identify thoracentesis techniques for minimizing the risk of complications by performing a systematic review the evidence...
June 18, 2014: JAMA
https://read.qxmd.com/read/23989984/does-this-patient-have-obstructive-sleep-apnea-the-rational-clinical-examination-systematic-review
#20
REVIEW
Kathryn A Myers, Marko Mrkobrada, David L Simel
IMPORTANCE: Obstructive sleep apnea is a common disease, responsible for daytime sleepiness. Prior to referring patients for definitive testing, the likelihood of obstructive sleep apnea should be established in the clinical examination. OBJECTIVE: To systematically review the clinical examination accuracy in diagnosing obstructive sleep apnea. DATA SOURCES: MEDLINE and reference lists from articles were searched from 1966 to June 2013. Titles and abstracts (n = 4449) were reviewed for eligibility and appraised for evidence levels...
August 21, 2013: JAMA
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