This week we have a new study from the fabulous Jeffrey Kline looking at whether the probability of a patient’s smile affects the likelihood of a positive diagnosis for PE.
Jeff has an amazing track record in PE research. He’s also a competitive bodybuilder which has nothing to do with PE, research or this article, it’s just that I am really impressed.
At first glance this may seem a bit weird and perhaps you were going to look at whether SMILE was an acronym for some new scoring system, but no. We are really talking about smiles from the patient. I find this stuff fascinating as I’m a great believer that we pick up subtle clues from patients that influence our perception of illness and thus affect our decisions. No doubt you will all have experienced the patient who ‘looks sick’ but the numbers are OK. That sixth sense, gestalt, judgement, whatever you wish to call it is important. It changes what we do and how we think but there is a paucity of research out there.
You may already have read Jeff’s work on facial expression in cardiovascular disease and if not you probably should which suggests that patients do have different facial reactions depending on their underlying diagnosis. Maybe there is something in this.
I think when it comes to diagnosis of PE, the largest research need is in the few seconds when patient and doctor meet; the dyadic interplay
— jeffrey kline (@klinelab) July 15, 2016
In this EMJ paper the question of the smile is examined. The abstract is below (but read the full paper please). Does it make a difference. Well yes and no would be a fair conclusion. It changes the way that we think but perhaps not what we do.