Yager J, Linn L S, Leake B, Gastaldo G, Palkowski C
Gen Hosp Psychiatry. 1986 May;8(3):145-51. doi: 10.1016/0163-8343(86)90072-1.
A sample of 146 physicians from internal medicine, family medicine, and psychiatry responded to two written clinical vignettes describing patients with combinations of commonly seen somatic and psychologic complaints. The physicians included housestaff of all levels of training, full-time academic faculty, and community-based clinical faculty. Enormous variation was seen in all specialties in the numbers and types of problems and diagnoses suggested by the physicians. Aside from one or two areas, there were few differences among the specialties or by level of training with regard to the numbers or types of problems identified and tentative diagnoses recorded. The variability within specialty groups was greater than among the groups. Physician behavior in response to one vignette was highly correlated with responses to the second vignette.
来自内科、家庭医学和精神病学的146名医生对两份书面临床案例进行了回应，这些案例描述了患有常见躯体和心理症状组合的患者。参与的医生包括各级培训的住院医师、全职学术教员和社区临床教员。所有专业的医生所提出的问题数量、类型以及诊断建议都存在巨大差异。除了一两个领域外，各专业之间或不同培训水平在识别出的问题数量或类型以及记录的初步诊断方面几乎没有差异。专业组内的变异性大于组间变异性。医生对一个案例的反应与对第二个案例的反应高度相关。
