UNLABELLED: The aim of the study was to relate the physical signs of the chest to the degree of airflow obstruction in asthma and COPD. METHODS: 113 patients with COPD and 76 patients with asthma were recruited from general practice. A standard physical examination of the chest was performed by trained medical students. Physical signs were related to the degree of airflow obstruction. RESULTS: the signs correlating closely with the degree of airflow obstruction were: a prolonged expiratory phase, low-standing diaphragm, decreased expiratory breath sounds, noisy inspiratory sounds, and decreased diaphragmatic excursions. There was a fair correlation between the number of physical signs and the degree of airflow obstruction. This was especially the case in asthma (r = 0.62), but it was less clear in COPD (r = 0.45). Sensitivity of separate physical signs to detect airflow obstruction was less than 50%, but at least one of the signs was present in 70% of the patients with obstruction. Specificity of separate signs was more than 85%, apart from wheezing in asthma. CONCLUSION: the combination of physical signs can offer relevant information in monitoring the severity of airflow obstruction in asthma and COPD.
UNLABELLED: The aim of the study was to relate the physical signs of the chest to the degree of airflow obstruction in asthma and COPD. METHODS: 113 patients with COPD and 76 patients with asthma were recruited from general practice. A standard physical examination of the chest was performed by trained medical students. Physical signs were related to the degree of airflow obstruction. RESULTS: the signs correlating closely with the degree of airflow obstruction were: a prolonged expiratory phase, low-standing diaphragm, decreased expiratory breath sounds, noisy inspiratory sounds, and decreased diaphragmatic excursions. There was a fair correlation between the number of physical signs and the degree of airflow obstruction. This was especially the case in asthma (r = 0.62), but it was less clear in COPD (r = 0.45). Sensitivity of separate physical signs to detect airflow obstruction was less than 50%, but at least one of the signs was present in 70% of the patients with obstruction. Specificity of separate signs was more than 85%, apart from wheezing in asthma. CONCLUSION: the combination of physical signs can offer relevant information in monitoring the severity of airflow obstruction in asthma and COPD.
Authors: J J den Otter; G M Reijnen; W J van den Bosch; C P van Schayck; J Molema; C van Weel Journal: Br J Gen Pract Date: 1997-08 Impact factor: 5.386