A Primer on the Precision and Accuracy of the Clinical Examination

THIS background paper will introduce and explain the terms and concepts that are being employed in the series of overviews on the rational clinical examination that begins in this issue ofTHE Journal. It includes definitions and explanations of certain key concepts, clinical examples, guides for reading clinical journals about a diagnostic test, and a blank "working table" that you can use to apply the concepts on your own. Accordingly, you may want to clip all or part of this and keep it handy as you read the overviews in this and subsequent issues. See also pp 2645 and 2650. Later background papers in this series will discuss selected issues in the precision and accuracy of the clinical examination in greater detail, or extend them to more complex diagnostic situations (readers who are impatient for these extensions can read about them now1). Of course, the precision and accuracy of