|Role of History Taking in Differential Diagnosis of Small Airway Disease: A Pilot Study on 32 Cases|
|Ali Amiri1,2, Seyyed Amir Yasin Ahmadi3, Afshin Hasanvand4|
|1Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
2Deviation of Pulmonary Diseases, Department of Internal Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
3Scientific Society of Evidence-Based Knowledge, Research Office for the History of Persian Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
4Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
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Keywords : small airway disease, pulmonary disease, COPD, medical history
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Objectives: Since history taking is still the most important part of medical diagnosis we were trying to find sensitive and specific symptoms and risk factors in order to differentiate small airway disease from other pulmonary patients. The evaluated social and past medical history related factors were using spirits of salt (HCL), gastro-esophageal reflux disease (GERD), etc.
Materials and Methods: The present pilot study consists of 32 cases of small airway disease and 28 cases from other pulmonary patients. The statistical evaluations were performed through 2 by 2 tables using Fisher's exact test corrected with Bonferroni's correction for P values and Yate's correction for odds ratios. The sensitivities and the specificities were also reported as we aimed. This study and its data have been approved in the ethic committee of Lorestan University of Medical Sciences, Iran.
Results: Among the 4 symptoms evaluated, having sputum was against small airway disease (Pc=0.0184; ORc=0.23). Lack of sputum was 62% sensitive and 75% specific for small airway disease. Among the risk factors evaluated using HCL was the most accurate point (Pc=0.0004; ORc=31.4; Sensitivity=65%; Specificity=96%; Accuracy=80.5%).
Conclusion: History taking is still the most important part of medical diagnosis. Through a suggestive history and physical examination we can reach a good pretest probability for further evaluation.
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