![]() Factors independently associated with correct examination findings included AAA diameter (odds ratio, 1.95 per centimeter increase 95% CI, 1.06-3.58) abdominal girth (OR, 0.90 per centimeter increase 95% CI, 0.87-0.94) and the examiner's assessment that the abdomen was not tight (OR, 2.68 95% CI, 1.17-6.13).Ĭonclusions Abdominal palpation has only moderate overall sensitivity for detecting AAA, but appears to be highly sensitive for diagnosis of AAAs large enough to warrant elective intervention in patients who do not have a large girth. When girth was less than 100 cm and the AAA was 5.0 cm or larger, sensitivity was 100% (12 examinations). When girth was 100 cm or greater and the aorta was palpable, sensitivity was 82%. Sensitivity in subjects with an abdominal girth less than 100 cm (40-in waistline) was 91% vs 53% for girth of 100 cm or greater ( P<.001). Sensitivity increased with AAA diameter, from 61% for AAAs of 3.0 to 3.9 cm, to 69% for AAAs of 4.0 to 4.9 cm, 72% for AAAs of 4.0 cm or larger, and 82% for AAAs of 5.0 cm or larger. Interobserver pair agreement for AAA vs no AAA between the first and second examinations was 77% (κ = 0.53). ![]() Results The overall accuracy of abdominal palpation for detecting AAA was as follows: sensitivity, 68% (95% confidence interval, 60%-76%) specificity, 75% (95% CI, 68%-82%) positive likelihood ratio, 2.7 (95% CI, 2.0-3.6) negative likelihood ratio 0.43 (95% CI, 0.33-0.56). Methods Two hundred subjects (aged 51-88 years), 99 with and 101 without AAA as determined by previous ultrasound, each underwent physical examination of the abdomen by 2 internists who were blinded to each other's findings and to the ultrasound diagnosis. Shared Decision Making and Communicationīackground Abdominal palpation during physical examination is an important means of detecting abdominal aortic aneurysm (AAA), but limited information is available on its accuracy. ![]() Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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