DALLAS – Sept. 16, 2008 – Patient history and physical examination, traditionally the cornerstone diagnostic tool for medical care, may still be among the most accurate and cost-efficient methods to assess patients with congestive heart failure, UT Southwestern Medical Center researchers have found.
Such time-honored techniques have diminished in importance in recent years as doctors have come to rely on high-tech diagnostic approaches, such as imaging and measuring biomarkers.
In today's issue of Circulation: Heart Failure, however, UT Southwestern and other researchers have found that the history and physical exam are still viable.
Researchers found that the estimates of the amount of fluid from the history and physical exam compared favorably to the results of the invasive measurements.
Additionally, patients who were estimated to have extra fluid through the collection of histories and physical exams were found to be at increased risk of being hospitalized or dying over the next six months.
"Our study touches upon an important clinical question: If physicians were more adept at performing histories and physicals, would they rely less on more costly diagnostic tests?" said Dr. Drazner.
"Hopefully, this study might shift the pendulum back just a bit towards using the history and physical examination in patient care. It might even get trainees more interested in learning about the history and physical examination so that this important art can be perpetuated in future generations of physicians."
The ESCAPE trial was conducted at 26 sites in the U.S. and Canada. Scientists from Duke University Medical Center, Ohio State University Medical Center, Washington Hospital Center, Brigham and Women's Hospital, the University of Minnesota, Johns Hopkins Hospital and Cleveland Clinic Foundation also contributed to this study.
The ESCAPE trial was supported by the National Heart, Lung and Blood Institute and an American Heart Association National Scientist Development Award.
Visit http://www.utsouthwestern.edu/heartlungvascular to learn more about UT Southwestern's clinical services in heart disease.
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