—We thank Dr Coyle and Dr Lubic for their comments. Unfortunately, we are not aware of any rigorous studies in which the precision and accuracy of either ophthalmodynamometry or carotid bruits in diastole have been evaluated. The purpose of the series on the rational clinical examination1 is to ensure that clinicians are aware of and practice examination techniques that have been demonstrated to be useful, abandon those that have not, and conduct research into those that are promising but unproven. We feel that ophthalmodynamometry and auscultation for carotid bruits in diastole fall into the last category, and we look forward to the results of methodologically rigorous studies evaluating their usefulness. If Coyle and Lubic are aware of any, we would like to hear from them.
Laupacis A, Østbye T, Feagan B, Sackett DL, Sauvé J. Detection of Carotid Stenosis by Physicial Examination-Reply. JAMA. 1994;271(24):1908. doi:10.1001/jama.1994.03510480032028