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November 1997

Diagnostic Accuracy and Precision in Assessing Dermatologic DiseaseProblem or Promise?

Author Affiliations

From the Center for Health Services Research in Primary Care (Dr Whited) and the Dermatology Service (Dr Hall), Durham Veterans Affairs Medical Center, and the Divisions of General Internal Medicine (Dr Whited) and Dermatology (Dr Hall), Duke University Medical Center, Durham, NC.

Arch Dermatol. 1997;133(11):1409-1415. doi:10.1001/archderm.1997.03890470083014

Although the clinical examination is important in all medical specialties, it is a critical element in the practice of dermatology. Virtually all dermatologic conditions are accessible for examination by visual inspection, and the clinical examination is often the sole diagnostic test obtained for directing the patient's care and therapy. A principal doctrine of dermatology and the entire practice of medicine is the importance of the clinical examination in formulating diagnoses and management plans. Too often, however, little is known regarding the true value of the clinical examination. Despite being the most accessible and used diagnostic test, the consistency and accuracy of the clinical examination are often not known. The concept of the clinical examination as a diagnostic test that can be described and evaluated in terms of its performance characteristics is a concept that is not familiar to all physicians. However, the clinical examination can and should be assessed as

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