What will you learn today?
•How the medicine is changing at the turn of the century?
•What are the most common illnesses and why?
•Subject «propaedeutics of internal diseases»
•History of physical examination and main diagnostic methods
•Physical examination vs modern medical technologies
Novel methods of treatment and diagnostics
•Very expensive
•Safety problems
•Inappropriate for public events
Additional methods of investigation
Principles of choice
•Information?
•Discomfort/Risk?
•Which material?
Material intake and storage?
•Price?
•Usefullness of the results?
•Risk/protection of the staff
Task of the day
Need in mathematical assessment of diagnostic value of physical examination in different situations
Results of the test and presence of the disease
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Disease |
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Present |
Absent |
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Positive |
True positive |
False positive |
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Test |
Negative |
False negative |
True negative |
Physical examination: method from the past or the base of clinical diagnosis?
PE is not only one of the main diagnostic methods but also a base for doctor-patient relationships.
New methods can only add to and clarify the data received from PE which remains the cornerstone of the diagnostics
and students teaching
Anderson R.C. Am. J. Med. 2001; 110: 419-23
«It`s easier for the doctor to decode instrument readings than to get a skill in patient`s examination and making a good medical record»
Е.М. Tareev
Three things make the medicine: the disease, the patient and the doctor. Any medical skill will be in vain if the patient will not cooperate with the doctor
Paracelsus
Evolution of the relations «doctor – patient»
Methods of physical examination in the XXI century 1/2
•Only while talking to a patient the doctor can get patient`s trust and understand the underlying cause of the disease
•Accurate PE helps to avoid excessive investigation, lower the spending of the drugs and the shorten the hospitalization duration
•Reality: main information is acquired from the results of laboratory and imaging methods