Taking the pressure off the patient - understanding digital rectal examinations on a real subject
File(s)
Accepted version
Author(s)
Type
Journal Article
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.
Date Issued
2020-10-01
Date Acceptance
2020-02-01
Citation
IEEE Transactions on Biomedical Engineering, 2020, 67 (10), pp.2798-2805
ISSN
0018-9294
Publisher
Institute of Electrical and Electronics Engineers
Start Page
2798
End Page
2805
Journal / Book Title
IEEE Transactions on Biomedical Engineering
Volume
67
Issue
10
Copyright Statement
© 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.
Sponsor
Engineering & Physical Science Research Council (EPSRC)
Engineering & Physical Science Research Council (E
Health Education North West London
Imperial Health Charity
Imperial College Healthcare NHS Trust
Engineering & Physical Science Research Council (EPSRC)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32031926
Grant Number
n/a
EP/K503733/1
Funder to provide
161715a
H0019097
EP/J018201/1
Subjects
0801 Artificial Intelligence and Image Processing
0903 Biomedical Engineering
0906 Electrical and Electronic Engineering
Biomedical Engineering
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2020-02-05