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September 2, 1922


Author Affiliations

New York
From the Department of Traumatic Surgery, New York Post-Graduate Medical School and Hospital.

JAMA. 1922;79(10):824-825. doi:10.1001/jama.1922.26420100003014b

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To appraise the outcome of a given injury we are in the habit of using some such descriptive prefix as "good," "fair," "poor" or "bad," and in other surgical or medical conditions we often make use of the terms "improved" or "unimproved," having an anatomic or surgical cure in mind.

Any such nomenclature is, of course, very confusing; it is not wholly descriptive nor is it reasonably accurate, as in no instance is there any verbal or other accepted standard of rating. This indicates that the present scheme of classifying end-results depends wholly on the personal equation of the examiner. One examiner may rate the outcome as "good"; another, equally competent, may rate the end-result in the same case as "fair." Obviously, both examiners cannot be right, and they differ because each has an arbitrary standard to which they have not mutually subscribed.

It is conceded that it is impossible

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