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David L. Simel, MD, MHS; Drummond Rennie, MD

JAMA. 1997;277(7):572-574.

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

JAMA introduced The Rational Clinical Examination series in 1992. The founder of the series, David Sackett, writing with one of us¹ (D.R.), observed that the history and physical examination (together, the clinical examination) frequently supplied all that was needed for a diagnosis, permitted physicians to rule out diagnostic hypotheses, could identify patients at early stages of their diseases, and played an important role in developing rapport with the patient.

See also p 564.

Sackett and Rennie noted that though facts gleaned from the clinical examination were like laboratory tests in that they had measurable sensitivities, specificities, and predictive powers, investigation of the precision and accuracy of the clinical examination had lagged behind that of more expensive (and perhaps less therapeutic) laboratory tests. They suggested this was because such investigation was arduous and not easily undertaken by those taught to rely on the laboratory; because the clinical diagnosis rarely resides . . . [Full Text PDF of this Article]

Author Affiliations
From the Durham Veterans Affairs Medical Center, Duke University, Durham, NC (Dr Simel). Dr Rennie is Deputy Editor (West), JAMA.

Footnotes
Reprints: David L. Simel, MD, MHS, Durham Veterans Affairs Medical Center, 508 Fulton St (558/152), Durham, NC 27705 (e-mail:sime1001@mc.duck.edu).

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