title: The value of abdominal examination in the diagnosis of abdominal aortic aneurysm.
abstract: BACKGROUND
  There is considerable variability in the reported value of clinical examination in the diagnosis of abdominal aortic aneurysms (AAA). This study aims to assess accuracy of abdominal examination by a doctor, a nurse and the patient in the diagnosis of AAA and whether this accuracy is related to the size of the aneurysm and/or the BMI of the patient.
  
  
  METHODS
  164 patients, 138 men and 26 women, median age 71 years, consented to participate in this prospective, single blind, controlled study. Thirty-nine patients attending for carotid duplex were used as controls. Abdominal examination was performed by a doctor and a nurse. Patients then performed self-examination.
  
  
  RESULTS
  Examination by a doctor, a nurse and the patient were similar in accuracy in diagnosing/excluding AAA which was directly related to AAA size and patient BMI. The Negative Predicted Value of abdominal examination exceeds 0.9 with AAA diameters > or =4 cm and the Positive Predictive Value exceeds 0.8 with AAA diameters > or =5 cm.
  
  
  CONCLUSIONS
  Abdominal examination by a doctor, a nurse and the patient is of value in the exclusion and diagnosis of significant AAA. It should be promoted and may represent a useful adjunct to population screening with ultrasound.
authors.affiliation: Academic Vascular Unit, Vascular Laboratory, Alderson House, Hull Royal Infirmary, Hull, East Yorkshire HU3 2JZ, UK.
authors.forename: A K
authors.initials: AK
authors.lastname: Venkatasubramaniam
authors.forename: T
authors.initials: T
authors.lastname: Mehta
authors.forename: I C
authors.initials: IC
authors.lastname: Chetter
authors.forename: J
authors.initials: J
authors.lastname: Bryce
authors.forename: P
authors.initials: P
authors.lastname: Renwick
authors.forename: B
authors.initials: B
authors.lastname: Johnson
authors.forename: A
authors.initials: A
authors.lastname: Wilkinson
authors.forename: P T
authors.initials: PT
authors.lastname: McCollum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D010865:Pilot Projects; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method