The last century of symptom-oriented research in emergency presentations – have we made any progress?

This review is dedicated to the last century of symptom-oriented research, taking three symptom complexes as typical examples of medical progress, and focusing on emergency presentations. Landmark publications in each area are discussed, with an attempt to focus on the methods used to achieve...

Full description

Bibliographic Details
Main Authors: Roland Bingisser, Christian Hans Nickel
Format: Article
Language:English
Published: SMW supporting association (Trägerverein Swiss Medical Weekly SMW) 2013-09-01
Series:Swiss Medical Weekly
Subjects:
Online Access:https://www.smw.ch/index.php/smw/article/view/1747
_version_ 1797979602738479104
author Roland Bingisser
Christian Hans Nickel
author_facet Roland Bingisser
Christian Hans Nickel
author_sort Roland Bingisser
collection DOAJ
description This review is dedicated to the last century of symptom-oriented research, taking three symptom complexes as typical examples of medical progress, and focusing on emergency presentations. Landmark publications in each area are discussed, with an attempt to focus on the methods used to achieve major breakthroughs. In abdominal pain, progress was achieved over a century ago by correlating symptoms and surgical pathology. Most diagnoses were made by using the clinical tools elaborated with careful observation and clinical examination. Together with the later reported outcomes, surgeons had an early and powerful tool for symptom-oriented research. In dyspnoea, progress was achieved much later, as a universal definition had to be elaborated over decades by consolidating clinical research, predominantly symptom-pathology correlation, and experimental research, such as function testing and experiments with animals and humans. In nonspecific presentations in emergency situations, progress has been achieved only recently, most probably owing to the fact that elderly patients are presenting in steeply increasing numbers, and the hallmark of disease presentation in the elderly seems to be less specific symptoms and complaints. This may be caused by altered physiology, polymorbidity, polypharmacy and the multiple difficulties encountered when taking histories in the elderly. Taken together, symptom-oriented research has been an important contributor to medical progress in the last century. Though it may be challenged by image- and laboratory-oriented research, it will remain part of patient-centred research because the epidemiology of symptoms, their clinical outcomes and their diagnostic importance according to severity will be the basis for the diagnostic process.   Key words: nonspecific disease presentation, symptom-oriented research, dyspnea, abdominal pain, elderly, geriatric emergency
first_indexed 2024-04-11T05:41:14Z
format Article
id doaj.art-61eb621200b64f44adcc4a4e4bcdef76
institution Directory Open Access Journal
issn 1424-3997
language English
last_indexed 2024-04-11T05:41:14Z
publishDate 2013-09-01
publisher SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
record_format Article
series Swiss Medical Weekly
spelling doaj.art-61eb621200b64f44adcc4a4e4bcdef762022-12-22T04:42:31ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972013-09-01143373810.4414/smw.2013.13829The last century of symptom-oriented research in emergency presentations – have we made any progress?Roland BingisserChristian Hans Nickel This review is dedicated to the last century of symptom-oriented research, taking three symptom complexes as typical examples of medical progress, and focusing on emergency presentations. Landmark publications in each area are discussed, with an attempt to focus on the methods used to achieve major breakthroughs. In abdominal pain, progress was achieved over a century ago by correlating symptoms and surgical pathology. Most diagnoses were made by using the clinical tools elaborated with careful observation and clinical examination. Together with the later reported outcomes, surgeons had an early and powerful tool for symptom-oriented research. In dyspnoea, progress was achieved much later, as a universal definition had to be elaborated over decades by consolidating clinical research, predominantly symptom-pathology correlation, and experimental research, such as function testing and experiments with animals and humans. In nonspecific presentations in emergency situations, progress has been achieved only recently, most probably owing to the fact that elderly patients are presenting in steeply increasing numbers, and the hallmark of disease presentation in the elderly seems to be less specific symptoms and complaints. This may be caused by altered physiology, polymorbidity, polypharmacy and the multiple difficulties encountered when taking histories in the elderly. Taken together, symptom-oriented research has been an important contributor to medical progress in the last century. Though it may be challenged by image- and laboratory-oriented research, it will remain part of patient-centred research because the epidemiology of symptoms, their clinical outcomes and their diagnostic importance according to severity will be the basis for the diagnostic process.   Key words: nonspecific disease presentation, symptom-oriented research, dyspnea, abdominal pain, elderly, geriatric emergency https://www.smw.ch/index.php/smw/article/view/1747nonspecific disease presentation symptom-oriented research dyspnea abdominal pain elderly geriatric emergency
spellingShingle Roland Bingisser
Christian Hans Nickel
The last century of symptom-oriented research in emergency presentations – have we made any progress?
Swiss Medical Weekly
nonspecific disease presentation symptom-oriented research dyspnea abdominal pain elderly geriatric emergency
title The last century of symptom-oriented research in emergency presentations – have we made any progress?
title_full The last century of symptom-oriented research in emergency presentations – have we made any progress?
title_fullStr The last century of symptom-oriented research in emergency presentations – have we made any progress?
title_full_unstemmed The last century of symptom-oriented research in emergency presentations – have we made any progress?
title_short The last century of symptom-oriented research in emergency presentations – have we made any progress?
title_sort last century of symptom oriented research in emergency presentations have we made any progress
topic nonspecific disease presentation symptom-oriented research dyspnea abdominal pain elderly geriatric emergency
url https://www.smw.ch/index.php/smw/article/view/1747
work_keys_str_mv AT rolandbingisser thelastcenturyofsymptomorientedresearchinemergencypresentationshavewemadeanyprogress
AT christianhansnickel thelastcenturyofsymptomorientedresearchinemergencypresentationshavewemadeanyprogress
AT rolandbingisser lastcenturyofsymptomorientedresearchinemergencypresentationshavewemadeanyprogress
AT christianhansnickel lastcenturyofsymptomorientedresearchinemergencypresentationshavewemadeanyprogress