RELIABILITY OF ELICITING PHYSICAL SIGNS IN EXAMINATION OF THE CHEST

作者: M.A. Spiteri , D.G. Cook , S.W. Clarke

DOI: 10.1016/S0140-6736(88)91613-3

关键词:

摘要: Agreement between 24 physicians on the presence or absence of respiratory signs was investigated. The were divided into six sets 4; each set examined 4 patients with well-defined chest signs. There generally poor agreement about particular Overall, in a complete only 55% time. Some such as wheezing seemed to be more reliably elicited than others whispering pectoriloquy. Comparison diagnoses based clinical findings correct supported by investigations showed that 28% physicians' incorrect. often examiners differed from majority sign, likely they make an incorrect diagnosis. A ranked order reliability which are would improve teaching medicine.

参考文章(9)
Lorrin M. Koran, The Reliability of Clinical Methods, Data and Judgments New England Journal of Medicine. ,vol. 293, pp. 642- 646 ,(1975) , 10.1056/NEJM197509252931307
D. Black, J A Strong, D. H Clark, The MRCP (UK) part II examination BMJ. ,vol. 283, pp. 313- 313 ,(1981) , 10.1136/BMJ.283.6286.313-B
R. S. F. Schilling, J. P. W. Hughes, I. Dingwall-Fordyce, Disagreement Between Observers in an Epidemiological Study of Respiratory Disease BMJ. ,vol. 1, pp. 65- 68 ,(1955) , 10.1136/BMJ.1.4905.65
H.C. Smyllie, L.M. Blendis, P. Armitage, OBSERVER DISAGREEMENT IN PHYSICAL SIGNS OF THE RESPIRATORY SYSTEM. The Lancet. ,vol. 286, pp. 412- 413 ,(1965) , 10.1016/S0140-6736(65)90759-2
D. Black, J A Strong, G. Shaw, Changes in MRCP (UK) examination BMJ. ,vol. 281, pp. 231- 231 ,(1980) , 10.1136/BMJ.281.6234.231-A
D. Mainland, Changes in MRCP (UK) examination BMJ. ,vol. 281, pp. 1219- 1219 ,(1980) , 10.1136/BMJ.281.6249.1219-A
CM. Fletcher, THE PROBLEM OF OBSERVER VARIATION IN MEDICAL DIAGNOSIS WITH SPECIAL REFERENCE TO CHEST DISEASES. Methods of Information in Medicine. ,vol. 3, pp. 98- 103 ,(1964) , 10.1055/S-0038-1636275
P. Armitage, L. M. Blendis, H. C. Smyllie, The Measurement of Observer Disagreement in the Recording of Signs Journal of the Royal Statistical Society. Series A (General). ,vol. 129, pp. 98- 109 ,(1966) , 10.2307/2343899