The New Zealand medical journal · 2014
Agreement of clinical measurements of liver size with ultrasound when performed by medical students.
Сравнительное исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hunter Selena A, Brimble Justin, Weatherall Mark, Galletly Duncan C
Аннотация
AIM: The accuracy of physical examination techniques in detecting liver disease is unclear. We sought to determine the perceived location of the lower liver border via scratch, percussion, palpation and ballottement with novice medical student examiners, compared with ultrasound localisation.
METHOD: Five novice medical students learnt four liver examination techniques and measured the lower liver border in 19 healthy volunteers. The difference between the examination technique and ultrasound (bias) and limits of agreement of each method were estimated by mixed linear models and shown using Bland-Altman- like plots.
RESULTS: All techniques had similar bias for the lower liver border, between 1.6 and 1.9 cm superior to the ultrasound measurement. Percussion had the smallest variability with increasing liver size. Limits of agreement were wide for all techniques, smallest for palpation (6.04 cm) and largest for scratch (7.2 cm) compared to the mean liver distance of 8 cm. Conclusion There was no difference in bias between the scratch, percussion, palpation and ballottement techniques regarding the lower liver border. All techniques had very wide limits of agreement, although palpation had the smallest. Liver size examination by novice medical students in healthy subjects is unreliable. Further research is needed using examiners with a different level of expertise and participants of varying body habitus and confirmed liver disease.
METHOD: Five novice medical students learnt four liver examination techniques and measured the lower liver border in 19 healthy volunteers. The difference between the examination technique and ultrasound (bias) and limits of agreement of each method were estimated by mixed linear models and shown using Bland-Altman- like plots.
RESULTS: All techniques had similar bias for the lower liver border, between 1.6 and 1.9 cm superior to the ultrasound measurement. Percussion had the smallest variability with increasing liver size. Limits of agreement were wide for all techniques, smallest for palpation (6.04 cm) and largest for scratch (7.2 cm) compared to the mean liver distance of 8 cm. Conclusion There was no difference in bias between the scratch, percussion, palpation and ballottement techniques regarding the lower liver border. All techniques had very wide limits of agreement, although palpation had the smallest. Liver size examination by novice medical students in healthy subjects is unreliable. Further research is needed using examiners with a different level of expertise and participants of varying body habitus and confirmed liver disease.