Volume 193 - Issue 3
How to examine patients
Author: Timothy P Usherwood
Med J Aust 2010; 193 (3): 180. || doi: 10.5694/j.1326-5377.2010.tb03842.x
Published online: 2 August 2010
Published online: 2 August 2010
Clinical examination. A systematic guide to physical diagnosis. 6th ed.
Nicholas J Talley, Simon O’Connor. Sydney: Churchill Livingstone, 2010 (xviii + 478 pp). ISBN 9780729539050.
“Talley and O’Connor” just keeps getting better. Written by Australian clinicians Nicholas Talley, currently Professor of Medicine and Epidemiology at Mayo Clinic in the United States, and Canberra-based cardiologist Simon O’Connor, the book was already an accessible and thorough guide to physical examination. Each successive edition brings extra features.
This sixth edition has tables of differential diagnoses for abnormal signs, more anatomical illustrations, and new sections on “examination anatomy”. There is useful advice on the examination of patients with a variety of important or common problems, and coverage of examination of the eyes, ears, nose and throat has been expanded. Many of the photographs of pathological signs and of physical examinations are clear and memorable.
The art of physical examination is evolving into a quantifiable science, and this edition adds information about interobserver reliability to the very important positive and negative likelihood ratios for key physical signs.
The accompanying DVD contains sequences illustrating a systematic approach to physical examination, hints on objective structured clinical examinations with suggestions for a more focused approach to a wide range of clinical problems, and libraries of images and electrocardiograms. The libraries would be useful for revision and self-testing as the accompanying text can be turned on or off. A website allows the full text to be searched online.
Inevitably, I have some criticisms. The paragraph on taking a history of illicit drug use is overly short and omits important issues. And if the patient was lying on a low bed, as in the DVD, I would prefer to palpate the abdomen from a sitting or kneeling position — or raise the bed! The escalating assessment of suicide risk should include questions about acts, not just feelings, thoughts and plans. But these are mostly minor points. The book remains excellent value for money, is a sound guide for students, trainees and more experienced clinicians working beyond their speciality, and is highly readable with a leavening of sly humour.
Shifting focus to adolescent wellbeing and inclusive participation in the digital age
Allyson R Todd, Elena Wang, Stephanie R Partridge
The clinical presentation, investigation, and management of women diagnosed with endometriosis in Australian general practices, 2011–2021: an open cohort study
Danielle Mazza, Kailash Thapaliya, Sharinne B Crawford, Alissia Hui, Maryam Moradi, Luke E Grzeskowiak
The impact of the Breast Screen NSW transition from film to digital mammography, 2002–2016: a linked population health data analysis
Rachel Farber, Nehmat Houssami, Katy J L Bell
Non‐technical errors associated with deaths in surgical care, Australia, 2012–2019, by surgical specialty (Australian and New Zealand Audit of Surgical Mortality): a retrospective cohort study
Jesse Ey, Victoria Kollias, Octavia Lee, Kelly Hou, Matheesha Herath, John B North, Ellie Treloar, Suzanne Edwards, Martin Bruening, Adam J Wells, Guy J Maddern
The CURE Asthma roadmap
Gary P Anderson, Anthony Flynn, Phil G Bardin, John D Blakey, Shyamali C Dharmage, Paul Foster, Peter G Gibson, Adam Jaffe, Alan James, Christine R Jenkins, Sundram Sivamalai, Peter D Sly, Guy B Marks, Vanessa M McDonald, Judy Wetttenhall
Evidence from Australian cohort studies about asthma trajectories and transitions across the life course: a narrative review
Caroline Lodge, Xin Dai, Ingrid A. Laing, Michael P Menden, Anthony Flynn, Gary P Anderson, Sarath Ranganathan, Shyamali C Dharmage