Elsevier

The Lancet

Volume 331, Issue 8590, 16 April 1988, Pages 873-875
The Lancet

Clinical Practice
RELIABILITY OF ELICITING PHYSICAL SIGNS IN EXAMINATION OF THE CHEST

https://doi.org/10.1016/S0140-6736(88)91613-3Get rights and content

Abstract

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

References (10)

  • CM. Fletcher

    The problem of observer variation in medical diagnosis with special reference to chest disease

    Meth Inform Med

    (1964)
  • Rsf Schilling et al.

    Disagreement between observers in an epidemiological study of respiratory disease

    Br Med J

    (1955)
  • LM. Koran

    The reliability of clinical methods, data and judgements

    N Engl J Med

    (1975)
  • D. Black et al.

    The MRCP (UK) part II examination

    Br Med J

    (1981)
There are more references available in the full text version of this article.

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