Physical exams still accurate, cost-efficient method to assess heart failure

Washington, Sept 17 : UT Southwestern Medical Center researchers have found that 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.

In recent years, such techniques have diminished in importance as doctors have come to rely on high-tech diagnostic approaches, such as imaging and measuring biomarkers.

However, UT Southwestern researchers have found that the history and physical exam are still viable.

History and physical examinations were performed for 388 patients enrolled in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial, and their findings were recorded on a standardized form.

About half of these patients also underwent an invasive right-heart catheterization to measure how much fluid they had in their body.

The researchers found that the estimates of the amount of fluid from the history and physical exam compared favourably to the results of the invasive measurements.

Also, 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 hospitalised 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. Mark Drazner, medical director of the Heart Failure and Cardiac Transplantation Program.

"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," he added.

The study is published in today's issue of Circulation: Heart Failure.

ANI