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Ann R Coll Surg Engl. 2000 Sep;82(5):336-8.

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

Author information

  • 1Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.

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.

PMID:
11041034
[PubMed - indexed for MEDLINE]
PMCID:
PMC2503602
Free PMC Article
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