Literature DB >> 11041034

The influence of experience and specialisation on the reliability of a common clinical sign.

D E Wallace1, G T McGreal, G O'Toole, P Holloway, M Wallace, E W McDermott, J Blake.   

Abstract

OBJECTIVES: To explore the influence of experience and specialisation on clinical judgement by comparing accuracy in diagnosing anaemia between a consultant general surgeon, a consultant ophthalmologist and their registrars. PATIENTS AND METHODS: Conjunctival inspection of 101 patients, subsequent correlation with haemoglobin concentration. MAIN OUTCOME MEASURES: Number of correct and incorrect diagnoses of anaemia.
RESULTS: 54 patients were anaemic and 47 were not. Overall accuracy in diagnosing anaemia ranged from 0.61-0.69, sensitivity 0.52-0.65 and specificity 0.62-0.83. Agreements between pairs of examiners were 0.68-0.81, with kappa values of 0.36-0.60 when adjusted for chance agreement.
CONCLUSIONS: Neither experience nor specialisation significantly influenced our ability to diagnose anaemia, based on conjunctival inspection. Without critical analysis of clinical signs, we are unaware of their diagnostic limitations.

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Mesh:

Year:  2000        PMID: 11041034      PMCID: PMC2503602     

Source DB:  PubMed          Journal:  Ann R Coll Surg Engl        ISSN: 0035-8843            Impact factor:   1.891


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