• Med. Clin. North Am. · May 2018

    Review

    The Hypothesis-Driven Physical Examination.

    • Brian T Garibaldi and OlsonAndrew P JAPJDivision of General Internal Medicine, Department of Medicine, Office of Medical Education, University of Minnesota, 420 Delaware Street Southeast, MMC 284, Minneapolis, MN 55455, USA..
    • Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, 1830 East Monument Street, 5th Floor, Baltimore, MD 21205, USA. Electronic address: bgariba1@jhmi.edu.
    • Med. Clin. North Am. 2018 May 1; 102 (3): 433-442.

    AbstractThe physical examination remains a vital part of the clinical encounter. However, physical examination skills have declined in recent years, in part because of decreased time at the bedside. Many clinicians question the relevance of physical examinations in the age of technology. A hypothesis-driven approach to teaching and practicing the physical examination emphasizes the performance of maneuvers that can alter the likelihood of disease. Likelihood ratios are diagnostic weights that allow clinicians to estimate the post-probability of disease. This hypothesis-driven approach to the physical examination increases its value and efficiency, while preserving its cultural role in the patient-physician relationship.Copyright © 2017 Elsevier Inc. All rights reserved.

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