|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
2Division 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
CJMB 2018; 5: 091-094
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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 a medical diagnosis, we tried to find sensitive and specific symptoms and risk factors in order to differentiate small airway disease from other pulmonary diseases. Social factors as well as related past medical history including using spirits of salt (HCL), gastro-esophageal reflux disease (GERD) and so on were evaluated.
Materials and Methods: The present pilot study consists of 32 cases of small airway disease and 28 cases of other pulmonary diseases. The statistical evaluations were performed through 2 × 2 tables using Fisher exact test adjusted with Bonferroni correction for P values and Yate correction for odds ratios. The sensitivities and the specificities were also reported as we aimed.
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 showed the highest accuracy (Pc = 0.0004; ORc = 31.4; Sensitivity = 65%; Specificity = 96%; Accuracy = 80.5%). History taking is still the most important part of a medical diagnosis.
Conclusions: Through a suggestive history and physical examination, we can reach a good pretest probability for further evaluation.
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