A systematic review of tests of empathy in medicine

Abstract Background Empathy is frequently cited as an important attribute in physicians and some groups have expressed a desire to measure empathy either at selection for medical school or during medical (or postgraduate) training. In order to do this, a reliable and valid test of empathy is required. The purpose of this systematic review is to determine the reliability and validity of existing tests for the assessment of medical empathy. Methods A systematic review of research papers relating to the reliability and validity of tests of empathy in medical students and doctors. Journal databases (Medline, EMBASE, and PsycINFO) were searched for English-language articles relating to the assessment of empathy and related constructs in applicants to medical school, medical students, and doctors. Results From 1147 citations, we identified 50 relevant papers describing 36 different instruments of empathy measurement. As some papers assessed more than one instrument, there were 59 instrument assessments. 20 of these involved only medical students, 30 involved only practising clinicians, and three involved only medical school applicants. Four assessments involved both medical students and practising clinicians, and two studies involved both medical school applicants and students. Eight instruments demonstrated evidence of reliability, internal consistency, and validity. Of these, six were self-rated measures, one was a patient-rated measure, and one was an observer-rated measure. Conclusion A number of empathy measures available have been psychometrically assessed for research use among medical students and practising medical doctors. No empathy measures were found with sufficient evidence of predictive validity for use as selection measures for medical school. However, measures with a sufficient evidential base to support their use as tools for investigating the role of empathy in medical training and clinical care are available.</p

Diagnosis of adrenal glands incidentaloma.

In this study the results of examination and treatment of 91 patients with adrenal glands incidentaloma were analyzed. According to the results of the morphological study, adenomas were the most common (n=60). Among malignant tumors, ACC was detected in 7 patients, low and undifferentiated cancer – in 3 patients, sarcoma – in 2 patients and metastasis of cancer – in 4 patients. To assess the nature of the tumor, the following criteria were used: size and density according to CT. In 43 patients with neoplasms less than4 cmin 9,3% of cases malignant adrenalomas occurred, at 4-6 cm(n=29) - in 17,2% of cases, more than6 cm(n=19) - in 31,6%. In patients with ACC, 71,4% of tumors exceeded6 cm, 28,5% - were within 4-6 cm, 14,1% - less than4 cm. The frequency of detection of malignant incidentalomas increases in proportion to the growth of tumor size, and with a diameter of more than4 cmit was 27,1%. Adrenal adenomas in 31.6% of cases were from 4 to6 cm, and in 10% - more than6 cm. Thus, the orientation only on the size of tumors did not provide enough convincing grounds for determining its malignant potential. High native density was noted in ACC (33.4±2.8 HU), ganglioneuroma (36.6 НU) and metastases of cancer (43.6±9.0 HU). Low density was found in adenomas (0.4±10.7 HU) and adrenal cysts (6.0±8.2 HU), p&lt;0.05. The most informative method of investigation in adrenal incidentalomas was CT, with sensitivity in adenomas and cancers – 98,3% and 94,4% respectively, specificity – 82,4% and 84,6%