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At least 433 records · Page 24Linked to original sources
PubMed2003

[Comparison of two measurement methods with a gold standard as applied to 20-MHz-sonography and clinical palpation for ascertaining the thickness of pigmented skin tumours].

AIM: This paper focuses on different statistical methods for comparing two measurement methods with an additionally available gold standard. A given data example is used as the basis of the calculations. METHOD: We provide a complementary statistical analysis of a study presented by Hoffmann et al. on sonometric and palpatory measurements of the size of pigmented skin tumours in 681 patients. RESULTS: For comparing two measurement methods with respect to a gold standard, several statistical parameters assessing one measurement method can be used. In addition, there are further descriptive and some inference-statistical methods available. CONCLUSION: If there is a suitable categorization of the measurements, the comparison of the methods should be performed using the positive predictive values and kappa coefficients as descriptive measures. Moreover, the McNemar test can be used for comparing the differential accuracy of allocation. When investigating continuous measurements, a comparison using mere correlation analyses can lead to false conclusions. Therefore, we recommend the direct analysis of the individual measurement errors by means of numerical and graphical representations. The absolute values of the measurement errors can be compared using the sign test for paired samples.

Biometry↗
PubMed1987

[Problem of pretherapeutic staging of cervical carcinoma. Studies of the diagnostic value of computerized tomography and magnetic resonance tomography in comparison with gynecologic palpation findings and pathologic-anatomic diagnosis].

In a prospective study of 20 cases, the importance of nuclear magnetic resonance as a diagnostic tool in cervix carcinoma was investigated. The results were compared with those of the Computer tomography as well as with those of the clinical examinations. The histology served as "Standard". In the evaluation of the local tumor invasion the gynecological examination appeared to be the most important. The involvement of regional lymph nodes was detected more accurately by the NMR as compared to CT. The exact clinical staging was not achieved by either method; thus these new diagnostic methods do not alter the planning and the technique of the operation.

Adult↗
PubMed2000

Better palpation of pain: reliability and validity of a new pressure pain protocol in TMD.

The purpose of this research was to employ a double-blind placebo control design of iontophoretically administered lidocaine to assess the test-retest reliability and validity of a magnitude matching procedure using a pressure algometer. In studies in the literature on assessment of pain in temporomandibular disorders (TMD), the pressure algometer has been found to be a reliable means of measuring pressure-pain threshold and a sensitive measure of treatment-response in the laboratory. However, previous research with this apparatus has not employed more sophisticated psychophysics. This study employs a magnitude matching psychophysical protocol to obtain a multidimensional pain report. Test-retest reliability over two occasions, 3-8 days apart, was found to be moderate for discriminability (r = .71, p < .01) but poor for response bias (r = .44). The validity study used iontophoresis as an anesthetic in a double-blind placebo and no-treatment control design. Although it was hypothesized that subjects in the anesthesia group would demonstrate reduced discriminability as compared with the control groups, no differences were found among the three groups on this measure. However, differences in response bias were found, with both the placebo control and no-treatment control groups differing from the experimental group but not from each other. Possible explanations and the implications of these findings are discussed.

Adult↗
PubMedDate not supplied

Are mammography and palpation sufficient for breast cancer screening? A dissenting opinion.

Breast cancer is an equal opportunity killer in that as many as 60%-70% of breast cancer patients have no obvious risk factor(s). Thus, the continued reliance on the importance of risk factors to initiate screening programs may inhibit further inquiry into better diagnostic and prognostic indicators. An extensive review of past and recent literature reveals that mammography is not an objective examination. Its use as a screening tool is facilitated among women 40 years old and older whose breast tissue is primarily fatty and provides better visualization. Younger women are not generally advised to use mammography because of its potentially hazardous effects associated with repeated use of radiation. More importantly, regardless of patient age, radiologists interpret mammograms, and different degrees of interpretation error exist for different radiologists as well as for the same radiologist performing the analysis after a period of time. Thus, the use of mammography as the sole screening tool does not provide patients or physicians with a sense of confidence about sensitivity and specificity. Further, recent enthusiasm to promote mammography screening may give women unrealistic expectations, leading them to falsely believe that a negative examination is assurance that cancer is not present in its earliest detectable stage. We propose to supplement the physical examination and mammography with a third screening modality based on thermal detection monitors. This is a noninvasive and nonradiogenic tool and might enable clinicians to provide patients with every opportunity for early diagnosis.

Adult↗
PubMed1996

The value of palpation, varicoscreen contact thermography and colour Doppler ultrasound in the diagnosis of varicocele.

Three non-invasive methods for the detection of a varicocele were evaluated in 63 men presenting with infertility. Physical examination, varicoscreen contact thermography and colour Doppler ultrasound were compared with spermatic venography as reference strategy. Physical examination had a sensitivity of 71%. Whether the non-palpable varicoceles are all subclinical is questionable since the specificity of physical examination was 69%. Varicoscreen proved be quick, easy and cheap but of no clinical value (sensitivity 97%, specificity 9%). Colour Doppler ultrasound using strict criteria was a good diagnostic tool (sensitivity 97%, specificity 94%). No imaging difference was seen with colour Doppler ultrasound among clinical and subclinical varicoceles. Since the debate on treating all degrees of varicocoeles is ongoing, we suggest that Doppler sonography should be a routine examination in infertile men.

Humans↗
PubMed1996

Maternal screening of childhood fever by palpation.

Fever is a common chief complaint for the pediatric emergency patient. It has been reported that a mother's tactile examination of a child, as historical information, offers little useful information. The study objective is to determine whether mothers can accurately detect the presence or absence of a fever without using a thermometer. The study is a prospective comparison of historical information with measured temperature, performed over a two-month period. The settings are in two inner-city university hospital emergency departments. Mothers of children less than 10 years old who presented to the emergency department with any chief complaint were selected as subjects. The interventions were interviewing the mother and the performance of routine vital signs on the child. Three hundred and twenty-two mothers participated. Of 124 febrile children, 104 mothers accurately detected a fever in their children (sensitivity 84%), while of 198 afebrile children, 150 mothers accurately detected the absence of fever (specificity 76%). We conclude that mothers are able to provide accurate information about the presence or absence of fever in their children by touch and without the use of a thermometer. Thus emergency physicians should heed the historical statements of mothers presenting with only the subjective complaints of fever and no history of thermometer use.

Chicago↗
PubMed1976

Congenital absence of the left pericardium: an unusual palpation finding and echocardiographic demonstration of the defect.

A patient with classical clinical and roentgenographic features of congenital absence of the left pericardium is described. On physical examination in the supine position, the precordial apical impluse was markedly displaced laterally. In the left lateral decubitus position, however, the apical impulse was felt in a mor medial location. This apparently paradoxical movement of the apical impulse was not found in persons with normal hearts or with left ventricular enlargement of hypertrophy, and may be characteristic of the pericardial defect. Further, with echocardiography we were able to demonstrate the absence of a pericardial echo on the lateral surface of the heart. Thus, echocardiography may be a useful noninvasive tool in the diagnosis of this defect.

Adult↗