Open Journal of Respiratory Diseases, 2020, 10, 49-58 https://www.scirp.org/journal/ojrd ISSN Online: 2163-9418 ISSN Print: 2163-940X DOI: 10.4236/ojrd.2020.103006 Jul. 31, 2020 49 Open Journal of Respiratory Diseases Is Pulmonary Auscultation Alone Sufficient for Clinical Practice? Waldo Luis Leite Dias de Mattos 1,2,3* , João Vitor Pinotti Dallasen 1 , Ana Gabriela Goularte Juchem 1 , Douglas da Silva Pinos 3 , Fabiana Jaeger 3 1 Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil 2 Santa Casa de Misericórdia Hospital, Porto Alegre, Brazil 3 Nossa Senhora da Conceição Hospital, Porto Alegre, Brazil Abstract Objective: The clinical examination is the basis for the diagnosis and rational choice of complementary tests. The aim of the study was to evaluate the per- formance of auscultation of the chest for screening of disease and for predict- ing the presence of abnormalities in the other domains of the chest examina- tion. Methods: Patients with COPD, atelectasis, pleural effusion, pneumonia and controls were evaluated by two examiners in the absence of any clinical information, initially only with pulmonary auscultation, and then in the other domains of chest examination. Results: 192 physical examinations were per- formed in 104 patients. An abnormal pulmonary auscultation had a sensitivity of 85.2%, positive predictive value (PPV) of 84.1%, positive likelihood reason (LR) of 1.53 (95% CI; 1.16 to 2.01) and negative LR of 0.33 (95% CI; 0.2 to 0.56) to identify the presence of any disease, and also a positive LR of 2.23 (95% CI; 1.02 to 4.9) and a negative LR of 0.3 (95% CI; 0.17 to 0.51) to predict additional abnormalities. A normal auscultation showed low accuracy to iden- tify healthy individuals, with sensitivity, specificity, NPV and PPV, respective- ly, of 44%, 43%, 41% and 46%. The agreement between the examiners consi- dering normal versus abnormal findings showed kappa = 0.76 for any changes in the physical examination present (p < 0.0001). Conclusions: Auscultation of the chest alone, may not be a sufficient strategy to track diseases or establish whether continuity of the examination is necessary or not. Keywords Physical Examination, Pulmonary Auscultation, Clinical Diagnosis 1. Introduction Until the middle of the last century, the clinical examination was practically the How to cite this paper: de Mattos, W.L.L.D., Dallasen, J.V.P., Juchem, A.G.G., da Silva Pinos, D. and Jaeger, F. (2020) Is Pulmonary Auscultation Alone Sufficient for Clinical Practice? Open Journal of Res- piratory Diseases, 10, 49-58. https://doi.org/10.4236/ojrd.2020.103006 Received: May 27, 2020 Accepted: July 28, 2020 Published: July 31, 2020 Copyright © 2020 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access