Étude sur l’apport de l’interrogatoire et de l’examen physique soigneux, dans le diagnostic final d’une pathologie en consultation de médecine interne : INPHYDIA

Abstract : The clinical exam constitutes an essential part of the medical consultation. However, with the progress of complementary exams, it is often neglected and its teaching is sometimes perceived as abandoned for the benefit of lectures. Yet, all these paraclinical exams are expensive and can be harmful. In this study, we wanted to assess the contribution of every stage of a medical consultation (history, physical and paraclinical exams) in the clarification of diagnoses in internal medicine. One hundred and five patients admitted for the first time in the department of internal medicine at the university hospital of Grenoble-Alpes for diagnostic opinion, between May and October 2018, were studied. The prospective collection of practitioners’ diagnostic assumptions was conducted at each stage of the consultation. The final diagnosis was deduced after reception of complementary exams’ results by the investigator. The complementary exams’ prices were retrospectively collected. About 70% of the diagnoses were suspected after having only conducted history, regardless of the practitioners’ qualification (resident, fellow, attending or professor) or the type of pathology (infectious, connective tissue disease, granulomatosis, psychosomatic, degenerative, etc.). The median total price of supplementary exams was estimated at €600 (USD 680). Thus, the contribution of the clinical examination, and specifically that of history, has not decreased in the diagnostic process, and there is an urgent need to reorganize medical pedagogy in order to put the clinical examination at the forefront of medical studies program.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [88 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02117820
Contributor : Jean-Hugues Morneau <>
Submitted on : Thursday, May 2, 2019 - 4:28:19 PM
Last modification on : Tuesday, May 7, 2019 - 1:23:57 AM

File

2019GREA5040_madelon_aurelie(1...
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02117820, version 1

Citation

Aurélie Madelon. Étude sur l’apport de l’interrogatoire et de l’examen physique soigneux, dans le diagnostic final d’une pathologie en consultation de médecine interne : INPHYDIA. Médecine humaine et pathologie. 2019. ⟨dumas-02117820⟩

Share

Metrics

Record views

100

Files downloads

231