PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of annrcseLink to Publisher's site
 
Ann R Coll Surg Engl. 2000 September; 82(5): 336–338.
PMCID: PMC2503602

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

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.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (391K), or click on a page image below to browse page by page.

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England