Breen A
Anglo-European College of Chiropractic, Bournemouth, England.
J Manipulative Physiol Ther. 1992 Jan;15(1):54-6.
Incompatibility between levels of reliability of physical examination techniques and their clinical usefulness produces an enormous chasm, into which any hope of accurate diagnosis falls and flounders. Bridging this chasm will require validation of the examination techniques along more than just observer variability lines. Greater attention to the use of gold standards is recommended, even though they themselves must be critically evaluated for the errors which they contain and for technicalities involved in developing elaborate and accurate standards.
体格检查技术的可靠性水平与其临床实用性之间的不相容性产生了一道巨大的鸿沟，任何准确诊断的希望都会跌入并陷入其中。弥合这一鸿沟不仅需要沿着观察者变异性的思路对检查技术进行验证。建议更加关注金标准的使用，尽管金标准本身也必须因其所包含的误差以及制定精细准确标准所涉及的技术细节而受到严格评估。
