The Reliability of Medical History and Physical Examination in Patients with Acute Abdominal Pain

The reliability of medical record information is of fundamental importance to the certainty with which a diagnosis can be made. 40 patients were chosen at random and each was examined by four clinicians. The information and a tentative diagnosis were written on a special record form. The results were judged by means of the coefficient kappa. The clinicians disagreed more on symptoms than on diagnoses. The diagnoses made by an automatic diagnosis system showed lower precision and lower accuracy than the clinicians’ diagnoses. The results of the study might explain why computer assistance in diagnostics is of limited value.

Die Zuverlässigkeit der Information aus dem Krankenblatt ist von grundlegender Bedeutung für die Sicherheit der Diagnose. 40 Patienten wurden zufällig ausgewählt. Jeder von ihnen wurde von vier Klinikern untersucht. Die Information und eine vorläufige Diagnose wurden auf einem besonderen Formular vermerkt. Die Ergebnisse wurden mit Hilfe des Koeffizienten Kappa beurteilt. Die Kliniker waren sich eher bezüglich der Symptome uneinig als bezüglich der Diagnosen. Die über ein automatisches Diagnosesystem erstellten Diagnosen waren ungenauer als die Diagnosen der Kliniker. Die Ergebnisse der Studie könnten erklären, warum die Computerunterstützung in der Diagnostik von begrenztem Wert ist.

Key-Words

Observer Variation - Medical History - Physical Examination - Computer-aided Diagnosis - Acute Abdominal Pain

Schlüssel-Wörter

Beobachtervariation - Krankengeschichte - ärztliche Untersuchung - computerunterstützte Diagnose - akute Bauchschmerzen

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