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Biomedical subjects

G A Corey

Publications and source records attributed to G A Corey.

9 recordsLinked to original sources
PubMed1990

Nasolaryngoscopy for family physicians.

Nasolaryngoscopy is easy to learn and safe and convenient to perform. It is readily accepted by patients and is a rich source of clinical information. The flexible nasolaryngoscope allows the physician to directly observe the anatomy of the nasal passages, pharynx and larynx. The procedure is helpful for identifying the etiology of chronic nasal complaints and hoarseness. Other possible indications for nasolaryngoscopy include suspected nasal foreign body, recurrent nasal or pharyngeal bleeding, and epiglottitis. With the use of this instrument, treatment of otolaryngologic conditions may be more specific, thereby reducing unnecessary referral or delay in treatment.

Endoscopy↗
PubMed1990

Rhinolaryngoscopy by family physicians.

A case series is presented consisting of 210 symptomatic patients evaluated by family physicians using fiberoptic rhinolaryngoscopy. The case series is analyzed to evaluate patient tolerance of the procedure, to measure the time required for the procedure, and to explore the clustering of diagnostic findings as they relate to presenting symptoms. Family physicians performed the examinations in an average of 4.4 minutes, with a median discomfort score of 2 on a scale of 0 to 10. A change in the diagnostic assessment or management plan following examination occurred in 90% of cases. Laryngeal pathology was identified in 73% of patients with chronic hoarseness, 60% of patients with both chronic hoarseness and nasal symptoms, and 3% of patients complaining of chronic nasal symptoms only. Nasal polyps or purulent drainage from the sinus ostia were found in 28% of patients with chronic nasal symptoms, 30% of patients with both chronic hoarseness and nasal symptoms, and 2% of patients with chronic hoarseness only. Incomplete examination (because of gagging) occurred in only 1 of 210 cases. This study demonstrated high diagnostic yield, rapid acquisition of technical skill, minimal patient discomfort, significant impact on diagnosis and management, and minimal time required for examination.

Clinical Competence↗
PubMed1987

Applying the acute ischemic heart disease predictive instrument.

A predictive instrument (or index) previously reported to be of value in reducing unnecessary coronary care unit admissions was tested in a randomized study. Acceptability to the physician was then measured by monitoring utilization in a subsequent nonrandomized phase and by debriefing. The predictive instrument retained predictive accuracy in the new setting with good correlation between predicted and actual risk of acute cardiac ischemia (r = 0.925). False-positive diagnosis rate decreased from 71 percent to 0.0 percent (P = .0096) in a subgroup admitted to the intermediate care unit, consistent with previously reported usefulness in low-risk patients. Acceptability was poor, however, with utilization rate of only 2.8 percent of eligible patients. Debriefing revealed low perceived usefulness. This problem will need to be addressed if widespread utilization is to occur. The criteria of predictive accuracy, usefulness, and acceptability are suggested as a standard panel for testing new predictive instruments.

Adult↗
PubMedDate not supplied

Preliminary study of rhinolaryngoscopy by family physicians.

Flexible fiberoptic rhinolaryngoscopy is an examination technique which has been widely accepted by otolaryngologists. Usefulness and acceptability of the technique was assessed in symptomatic patients in a family practice population. Collaborating family physicians performed 66 examinations, which required 4.6 +/- 0.60 minutes (mean +/- SD) to complete. The median patient discomfort score was 2 on a 0-10 scale ranging from "no discomfort" to "severe discomfort." Change in diagnosis by the primary physician was made in 13 of 18 patients, and change in management plan in 10 of 12 patients, after the examination. Important findings included primary diagnosis of a laryngeal carcinoma, unsuspected nasal polyps, and normal examinations of high quality. These preliminary findings suggest that flexible fiberoptic rhinolaryngoscopy by family physicians is a useful examination, requires little time, and is acceptable to patients. Further study is suggested before general use is advocated.

Family Practice↗