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Taking the Pressure Off the Patient - Understanding Digital Rectal Examinations on a Real Subject.

Granados, A; Cox, S; Low-Beer, N; Higham, J; Kneebone, R; Bello, F (2020) Taking the Pressure Off the Patient - Understanding Digital Rectal Examinations on a Real Subject. IEEE Trans Biomed Eng, 67 (10). pp. 2798-2805. ISSN 1558-2531 https://doi.org/10.1109/TBME.2020.2971826
SGUL Authors: Higham, Jennifer Mary

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Abstract

Better understanding of palpation techniques during unsighted physical examinations has mostly been limited to qualitative and quantitative studies of performance of experts whilst conducting examinations on plastic benchtop models. However, little is known about their performance when conducting such examinations on real subjects. OBJECTIVE: The aim of this paper is to better understand palpation techniques of experts whilst conducting a Digital Rectal Examination on a real subject. METHODS: We recruited four consultants from relevant specialties and asked them to conduct two DREs on a Rectal Teaching Assistant whilst wearing small position and pressure sensors on their examining finger. We segmented the relevant anatomy from an MRI taken of the pelvic region, registered 3D models and analysed retrospectively performance in relation to executed tasks, supination/pronation, palpation convex hull and pressure applied. RESULTS: Primary care consultants examined the anatomy more holistically compared to secondary care experts, the maximum pressure applied across experiments is 3.3N, overall the pressure applied on the prostate is higher than that applied to rectal walls, and the urologist participant not only applied the highest pressure but also did so with the highest most prominent frequency (15.4 and 25.3 Hz). CONCLUSIONS: The results of our research allow for better understanding of experts' technical performance from relevant specialities when conducting a DRE, and suggest the range of pressure applied whilst palpating anatomy. SIGNIFICANCE: This research will be valuable in improving the design of haptics-based learning tools, as well as in encouraging reflection on palpation styles across different specialities to develop metrics of performance.

Item Type: Article
Additional Information: © © 2020 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.
Keywords: Fingers, Pressure sensors, Task analysis, Hospitals, Pelvis, Irrigation, Tracking technology, pressure sensors, quantitative analysis, visualisation, palpation, imaging, performance, metrics, simulation, 0903 Biomedical Engineering, 0906 Electrical and Electronic Engineering, 0801 Artificial Intelligence and Image Processing, Biomedical Engineering
Journal or Publication Title: IEEE Trans Biomed Eng
ISSN: 1558-2531
Language: eng
Dates:
DateEvent
October 2020Published
5 February 2020Published Online
1 February 2020Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
UNSPECIFIEDEngineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
UNSPECIFIEDLondon DeaneryUNSPECIFIED
UNSPECIFIEDHealth Education North West LondonUNSPECIFIED
PubMed ID: 32031926
Web of Science ID: WOS:000571741600010
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112491
Publisher's version: https://doi.org/10.1109/TBME.2020.2971826

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