Raz E, Cohen S, Benbassat J
Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Isr J Med Sci. 1987 Dec;23(12):1177-80.
The admission diagnoses of 183 patients seen in the Emergency Room by 14 residents in surgery were compared with the discharge diagnoses of the same patients. The degree of accuracy of the admission diagnosis was rated by an experienced surgeon on a 0 to 4 scale for each patient, and the average diagnostic accuracy score was calculated for each resident. The residents' scores ranged from 2.0-3.3 (mean 2.6). The average diagnostic accuracy score was shown to be a discriminative measure. It correlated significantly with the quality of the initial diagnostic hypotheses, as measured by a written open-ended clinical simulation, but not with the success of the residents on the remaining parts of the written clinical simulation, with their peer and preceptor ratings, nor with the length of their training prior to testing.
14名外科住院医师在急诊室诊治的183例患者的入院诊断与这些患者的出院诊断进行了比较。由一位经验丰富的外科医生对每位患者的入院诊断准确性按0至4分进行评分，并计算出每位住院医师的平均诊断准确性得分。住院医师的得分范围为2.0 - 3.3（平均2.6）。平均诊断准确性得分被证明是一种具有区分性的指标。它与通过书面开放式临床模拟所衡量的初始诊断假设质量显著相关，但与住院医师在书面临床模拟其余部分的表现、同行及带教老师的评分均无关，也与测试前的培训时长无关。
