HELEN L. SMITS, M.D.
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To the editor: The article "Quality of Diagnostic Examinations in a University Hospital Outpatient Clinic," by Goetzl and associates (Ann Intern Med 78:481-489, 1973), contains a major defect in its basic reasoning. The authors assume, in the design of their study, that the "meticulous diagnostic evaluation" that is currently taught and practiced by academic specialists in internal medicine is a valuable and sufficient tool for the early detection of treatable disease.
There is little objective evidence to support that assumption. The authors' own results suggest that certain clearly defined parts of the physical examination, such as measuring vital signs and
SMITS HL. Diagnostic Examinations. Ann Intern Med. ;79:279–280. doi: 10.7326/0003-4819-79-2-279
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Published: Ann Intern Med. 1973;79(2):279-280.
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