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Clinical assessments have to be used in epidemiological studies in the absence of more objective means of establishing diagnosis or recording events in the natural history of disease. This requires the standardization of definition, technique and interpretation as a means of reducing observer variability in clinical examination. The methods used to reduce the observer variation in the clinical assessment of stroke patients are described and results are presented which demonstrate the degree to which this was achieved.
Garraway et al. (1976) studied this question.