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Andrew Holmes, MB, ChB, MPH
The Johns Hopkins University School of Hygiene and Public Health Baltimore, Md

JAMA. 1989;262(3):351.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The article entitled "The Sensitivity and Specificity of Clinical Diagnostics During Five Decades: Toward an Understanding of Necessary Fallibility"¹ fueled a spirited discussion in our journal club. For this I heartily congratulate the authors.

The article splendidly illustrates some problems with the medical literature. The authors introduced an interesting idea that could have been the subject of a brief essay or "op-ed," but the idea was presented as a scientific article complete with data and "Methods," "Results," and "Comment" sections. The result was turgid pseudo-science, posing as meta-analysis, which added nothing to the body of knowledge of science and contributed little to its understanding.

The studies, directly compared, ranged from autopsy rates of 96% to 23% to unknown; clinical diagnosis ranged from collaboration between clinician and pathologist to (presumably) routine completion of death certificates; the studies span the Atlantic; and no information is given about the . . . [Full Text PDF of this Article]

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