Assessment of accuracy of clinical techniques for detection of pleural effusions: comparison with radiological methods F. Deutsch, N. Ogawa, P. E. S. M. Gonzales, S. Kodaira, L. Camargo, M. A. Martins, J. A. Atta, I. F. L. C. Tibério (Sao Paulo, Brazil)
Source: Annual Congress 2002 - Aspects of respiratory disease in primary care
Session: Aspects of respiratory disease in primary care Session type: Thematic Poster Session Number: 2991
Abstract Evaluation of pleural effusions level without using radiological methods has impact in healthcare economics, as costs are a major issue even in industrialized countries. There are few data determining specificity, sensitivity and cost-effectiveness of clinical and radiological techniques used to identify and measure pleural effusions. We examined 21 patients with pleural effusions (11 men, 10 women, 45.3 ±] 6.4 years). Patients were evaluated independently by 2 examiners [a physician (C1) and a medical student (C2)]. We recorded respiratory frequency, regularity and depth, bulging of intercostal spaces, tactile fremitus, dullness, Signorelli sign, diminution or absence of breath sounds, pleural friction and egophony. Reference point used to measure the alterations was scapula's inferior border. At the end of examination observers recorded the upper limit of pleural effusion (C1-PE; C2-PE). Ultrasounds were performed by a single radiologist and the upper limit of effusion was also recorded (R-PE). We found no differences between the findings of C1 and C2 in the majority of aspects, except for Signorelli sign, not frequently identified by C2. Physicians relied more heavily on percussion alterations (p<0.05) and egophonia (p<0.05) to determine the level of the pleural effusion than other clinical signs. However, no isolated physical finding correlated with ultrasonografic limit of pleural effusion. We found no differences between the upper limit of pleural C1-PE, C2-PE and R-PE measures (mean±]SEM): (3.5±]1.0, 1.3±]0.9 and 3.0±]1.3, respectively). In conclusion physical examination either by a physician or a student was as accurate as ultrasound for determining level of pleural effusion.Rating:
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F. Deutsch, N. Ogawa, P. E. S. M. Gonzales, S. Kodaira, L. Camargo, M. A. Martins, J. A. Atta, I. F. L. C. Tibério (Sao Paulo, Brazil). Assessment of accuracy of clinical techniques for detection of pleural effusions: comparison with radiological methods. Eur Respir J 2002; 20: Suppl. 38, 2991
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