Diagnosis Of Obstructive Airways Disease Research Articles

The value of the forced expiratory time in the physical diagnosis of obstructive airways disease

The value of the forced expiratory time in the physical diagnosis of obstructive airways disease

Selected features of bedside clinical evaluation were predictive of obstructive airways disease

DiagnosisJuly 1, 1993Selected features of bedside clinical evaluation were predictive of obstructive airways diseaseGeorge J. Heymach, PhD, MDGeorge J. Heymach, PhD, MDUniversity of Pittsburgh, Pittsburgh, Pennsylvania, USA (G.J.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-1993-119-1-024 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinkedInRedditEmail Source CitationHolleman DR Jr, Simel DL, Goldberg JS. Diagnosis of obstructive airways disease from the clinical examination. J Gen Intern Med. 1993 Feb;8:63-8.Reference1 Clausen JL. The diagnosis of emphysema, chronic bronchitis, and asthma. Clin Chest Med. 1990;11:405-16. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Pittsburgh, Pittsburgh, Pennsylvania, USA (G.J.H.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails July 1, 1993Volume 119, Issue 1Page: 24KeywordsChronic bronchitisChronic obstructive pulmonary diseaseDecision makingDyspneaHospitalsMedical risk factorsPulmonary diseasesPulmonary functionSpecificitySpirometrySurgeryTechnicians ePublished: 9 March 2020 Issue Published: July 1, 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.Loading ...

Diagnosis of obstructive airways disease from the clinical examination

To determine the operating characteristics of history and physical examination items for pulmonary airflow obstruction. Prospective observational study. Medical Preoperative Evaluation Clinic at the Durham Veterans Affairs Medical Center. Consecutive patients referred for outpatient medical preoperative risk assessment. None. Number of years the patient had smoked cigarettes, patient-reported wheezing [LR+ (likelihood ratio for finding present) = 3.1; LR- (likelihood ratio for finding absent) = 0.58], and auscultated wheezing (LR+ = 12; LR- = 0.87) were independent predictors of obstructive airways disease from the history and physical examination. Forced expiratory time and peak expiratory flow rate, both measured by the clinician at the bedside, were additional independent predictors of airflow obstruction. A nomogram using patient-reported wheezing, number of years the patient had smoked, and auscultated wheezing was developed and validated (area under receiver operating characteristic curve = 0.78; p = 0.0001) for the bedside prediction of obstructive airways disease. Peak expiratory flow rate can be substituted for auscultated wheezing with similar predictive ability. The results of bedside clinical examinations predict the presence of obstructive airways disease. A nomogram based on a combination of four bedside findings predicts airflow obstruction as well as clinicians' overall clinical impressions.