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Clearly the best way to approach a search for physical findings is to conduct a physical examination of the patient guided by the patient's history. 

If a patient presents with a history strongly suggestive of involvement by an illness with the patient's cardiovascular system, it is probable that a complete neurological examination will not be done. But it is essential to include parts of that examination that speak to a cardiovascular problem. Syncope (passing out) is one example where both parts of a complete exam would be demanded.

So in this group of patients, our respondents, distance and transmissibility of the illness quickly appear as impediments if actual access for a physical examination was possible. Such "exams" are now commonly conducted in a telephone interview. This "solution" may have as many or more limitations as our questionnaire, especially since such exchanges are often rushed, when the questionnaire need not be. So we have allowed the patient, in one sense to do basic components of assessing physical findings, and within the limits of the questionnaire. 

The longer list of symptoms was regrouped into an organ systems approach.

Degree of physical limitation associaed with this illness was also sought after. Movement is essential to human existence. How has this illness impacted on such activity?

In both approaches to the impact of the illness on physical findings, responses have suggested quite useful distinctions.

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