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May 20, 1992, Vol 267, No. 19 >
ARTICLE | May 20, 1992

A Primer on the Precision and Accuracy of the Clinical Examination FREE

David L. Sackett, MD, MSc Epid, FRCPC
[+] Author Affiliations

Reprint requests to Henderson General Division, Room 408, McMaster Clinic, 711 Concession St, Hamilton, Ontario, Canada L8V 1C3 (Dr Sackett).


JAMA. 1992;267(19):2638-2644. doi:10.1001/jama.1992.03480190080037
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References

THIS background paper will introduce and explain the terms and concepts that are being employed in the series of overviews on the rational clinical examination that begins in this issue of THE Journal. It includes definitions and explanations of certain key concepts, clinical examples, guides for reading clinical journals about a diagnostic test, and a blank "working table" that you can use to apply the concepts on your own. Accordingly, you may want to clip all or part of this and keep it handy as you read the overviews in this and subsequent issues.

See also pp 2645 and 2650.

Later background papers in this series will discuss selected issues in the precision and accuracy of the clinical examination in greater detail, or extend them to more complex diagnostic situations (readers who are impatient for these extensions can read about them now1).

Of course, the precision and accuracy of

REFERENCES

1 +
Sackett DL, Haynes RB, Guyatt GH, Tugwell P. Clinical Epidemiology: A Basic Science for Clinical Medicine . 2nd ed. Boston, Mass: Little Brown & Co; 1991;.
2 +
Tabakoff B, Hoffman PL, Lee JM, Saito T, Willard B, de Leon-Jones F.  Differences in platelet enzyme activity between alcoholics and nonalcoholics. N Engl J Med . 1988;;318:134-139.
3 +
Ewing JA.  Detecting alcoholism: the CAGE questionnaire. JAMA . 1984;;252:1905-1907.
4 +
Lundberg GD.  Ethyl alcohol—ancient plague and modern poison. JAMA . 1984;;252:1911-1912.
5 +
Bush B, Shaw S, Cleary P, Delbanco TL, Aronson MD.  Screening for alcohol abuse using the CAGE questionnaire. Am J Med . 1987;;82:231-235.
6 +
Theodossi A, Knill-Jones RP, Skene A, et al.  Inter-observer variation of symptoms and signs in jaundice. Liver . 1981;;1:21-32.
7 +
Spiter MA, Cook DG, Clarke SW.  Reliability of eliciting physical signs in examination of the chest. Lancet . 1988;;1:873-875.
8 +
Knipschild P.  Looking for gall bladder disease in the patient's iris. BMJ . 1988;;297:1578-1581.
9 +
Simel DL, Halvorsen RA Jr, Feussner JR.  Quantitating bedside diagnosis: clinical evaluation of ascites. J Gen Intern Med . 1988;;3:423-428.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Sackett DL, Haynes RB, Guyatt GH, Tugwell P. Clinical Epidemiology: A Basic Science for Clinical Medicine . 2nd ed. Boston, Mass: Little Brown & Co; 1991;.
2 +
Tabakoff B, Hoffman PL, Lee JM, Saito T, Willard B, de Leon-Jones F.  Differences in platelet enzyme activity between alcoholics and nonalcoholics. N Engl J Med . 1988;;318:134-139.
3 +
Ewing JA.  Detecting alcoholism: the CAGE questionnaire. JAMA . 1984;;252:1905-1907.
4 +
Lundberg GD.  Ethyl alcohol—ancient plague and modern poison. JAMA . 1984;;252:1911-1912.
5 +
Bush B, Shaw S, Cleary P, Delbanco TL, Aronson MD.  Screening for alcohol abuse using the CAGE questionnaire. Am J Med . 1987;;82:231-235.
6 +
Theodossi A, Knill-Jones RP, Skene A, et al.  Inter-observer variation of symptoms and signs in jaundice. Liver . 1981;;1:21-32.
7 +
Spiter MA, Cook DG, Clarke SW.  Reliability of eliciting physical signs in examination of the chest. Lancet . 1988;;1:873-875.
8 +
Knipschild P.  Looking for gall bladder disease in the patient's iris. BMJ . 1988;;297:1578-1581.
9 +
Simel DL, Halvorsen RA Jr, Feussner JR.  Quantitating bedside diagnosis: clinical evaluation of ascites. J Gen Intern Med . 1988;;3:423-428.

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