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Value of medical history in ophthalmology: A study of diagnostic accuracy
PURPOSE: This study aimed to demonstrate the value of the chief compliant and patient history to accurately diagnose patient pathology without requiring ocular examination or imaging in an outpatient neuro-ophthalmology clinic. METHODS: We prospectively evaluated 115 consecutive patients at our inst...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277212/ https://www.ncbi.nlm.nih.gov/pubmed/30555971 http://dx.doi.org/10.1016/j.joco.2018.09.001 |
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author | Wang, Michelle Y. Asanad, Samuel Asanad, Kian Karanjia, Rustum Sadun, Alfredo A. |
author_facet | Wang, Michelle Y. Asanad, Samuel Asanad, Kian Karanjia, Rustum Sadun, Alfredo A. |
author_sort | Wang, Michelle Y. |
collection | PubMed |
description | PURPOSE: This study aimed to demonstrate the value of the chief compliant and patient history to accurately diagnose patient pathology without requiring ocular examination or imaging in an outpatient neuro-ophthalmology clinic. METHODS: We prospectively evaluated 115 consecutive patients at our institution from January to April 2009. The attending neuro-ophthalmologist committed to a single most likely diagnosis while solely being exposed to patient demographic information (age, gender, race) and chief complaint, but was otherwise blinded to ocular examination or imaging. The validity of the initial diagnosis was assessed by further acquiring subjective and objective findings and the percentage of correct diagnoses was determined. RESULTS: Patient cases were categorized based on the neuro-ophthalmologic localization of the final diagnoses: afferent nervous system, central nervous system (CNS), efferent nervous system, orbital system, and pupillary system. Correct diagnoses by chief complaint and patient history were 84%, 100%, 86%, 80%, 50% and 100% for afferent, central, efferent, orbit, pupil, and other neuro-ophthalmic diseases, respectively. Over half the cases were correctly diagnosed by chief complaint alone, which improved to 88% when combined with the patient history. CONCLUSIONS: A simple combination of patient history and chief complaint predicts an overall diagnostic accuracy in approximately 90% of cases. Our study demonstrates the remarkable diagnostic value of patient history in neuro-ophthalmologic clinic practice. |
format | Online Article Text |
id | pubmed-6277212 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-62772122018-12-14 Value of medical history in ophthalmology: A study of diagnostic accuracy Wang, Michelle Y. Asanad, Samuel Asanad, Kian Karanjia, Rustum Sadun, Alfredo A. J Curr Ophthalmol Article PURPOSE: This study aimed to demonstrate the value of the chief compliant and patient history to accurately diagnose patient pathology without requiring ocular examination or imaging in an outpatient neuro-ophthalmology clinic. METHODS: We prospectively evaluated 115 consecutive patients at our institution from January to April 2009. The attending neuro-ophthalmologist committed to a single most likely diagnosis while solely being exposed to patient demographic information (age, gender, race) and chief complaint, but was otherwise blinded to ocular examination or imaging. The validity of the initial diagnosis was assessed by further acquiring subjective and objective findings and the percentage of correct diagnoses was determined. RESULTS: Patient cases were categorized based on the neuro-ophthalmologic localization of the final diagnoses: afferent nervous system, central nervous system (CNS), efferent nervous system, orbital system, and pupillary system. Correct diagnoses by chief complaint and patient history were 84%, 100%, 86%, 80%, 50% and 100% for afferent, central, efferent, orbit, pupil, and other neuro-ophthalmic diseases, respectively. Over half the cases were correctly diagnosed by chief complaint alone, which improved to 88% when combined with the patient history. CONCLUSIONS: A simple combination of patient history and chief complaint predicts an overall diagnostic accuracy in approximately 90% of cases. Our study demonstrates the remarkable diagnostic value of patient history in neuro-ophthalmologic clinic practice. Elsevier 2018-09-27 /pmc/articles/PMC6277212/ /pubmed/30555971 http://dx.doi.org/10.1016/j.joco.2018.09.001 Text en © 2018 Iranian Society of Ophthalmology. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Wang, Michelle Y. Asanad, Samuel Asanad, Kian Karanjia, Rustum Sadun, Alfredo A. Value of medical history in ophthalmology: A study of diagnostic accuracy |
title | Value of medical history in ophthalmology: A study of diagnostic accuracy |
title_full | Value of medical history in ophthalmology: A study of diagnostic accuracy |
title_fullStr | Value of medical history in ophthalmology: A study of diagnostic accuracy |
title_full_unstemmed | Value of medical history in ophthalmology: A study of diagnostic accuracy |
title_short | Value of medical history in ophthalmology: A study of diagnostic accuracy |
title_sort | value of medical history in ophthalmology: a study of diagnostic accuracy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277212/ https://www.ncbi.nlm.nih.gov/pubmed/30555971 http://dx.doi.org/10.1016/j.joco.2018.09.001 |
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