Scholars@Duke
David Lee Simel

David Lee Simel

Professor Emeritus of Medicine
Medicine, General Internal Medicine
david.simel@duke.edu
Room C8010, Durham VA Med Ct., 508 Fulton St, Durham, NC 27705

Selected Publications

Audit-and-Feedback Utilizing Resident Consensus Standards Reduced Daily Labs.

Journal Article J Grad Med Educ · June 2025 Background The Choosing Wisely campaign recommends that clinicians avoid repetitive laboratory testing in hospitalized patients who have clinical and laboratory stability; however, it is unclear how physicians define laboratory stability, or how they adher ... Full text Open Access Link to item Cite

History and Physical Examination

Chapter · January 1, 2023 The clinical examination provides data that are part of a scientific inquiry and is also an important social ritual that establishes and maintains a relationship between the physician and patient. As part of a scientific inquiry, the physician should focus ... Full text Cite

Does This Patient With Acute Infectious Conjunctivitis Have a Bacterial Infection?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA · June 14, 2022 IMPORTANCE: Acute infectious conjunctivitis is characterized by ocular redness and discharge, and is a common clinical entity. Evidence-based tools to aid the clinical diagnosis of viral vs bacterial conjunctivitis are lacking and may contribute to overpre ... Full text Link to item Cite

Does This Adult Patient Have Hypertension?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA · July 27, 2021 IMPORTANCE: Office blood pressure (BP) measurements are not the most accurate method to diagnose hypertension. Home BP monitoring (HBPM) and 24-hour ambulatory BP monitoring (ABPM) are out-of-office alternatives, and ABPM is considered the reference standa ... Full text Link to item Cite

Multivariable risk scores for predicting short-term outcomes for emergency department patients with unexplained syncope: A systematic review.

Journal Article Acad Emerg Med · May 2021 OBJECTIVES: Emergency department (ED) patients with unexplained syncope are at risk of experiencing an adverse event within 30 days. Our objective was to systematically review the accuracy of multivariate risk stratification scores for identifying adult sy ... Full text Open Access Link to item Cite

Reply.

Journal Article J Pediatr · March 2021 Full text Link to item Cite

Does This Patient Have Hip Osteoarthritis?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA · December 17, 2019 IMPORTANCE: Hip osteoarthritis (OA) is a common cause of pain and disability. OBJECTIVE: To identify the clinical findings that are most strongly associated with hip OA. DATA SOURCES: Systematic search of MEDLINE, PubMed, EMBASE, and CINAHL from inception ... Full text Link to item Cite

Pain Management With Opioids in 2019-2020.

Journal Article JAMA · November 19, 2019 Full text Link to item Cite

Did This Patient Have Cardiac Syncope?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA · June 25, 2019 IMPORTANCE: Syncope can result from a reduction in cardiac output from serious cardiac conditions, such as arrhythmias or structural heart disease (cardiac syncope), or other causes, such as vasovagal syncope or orthostatic hypotension. OBJECTIVE: To perfo ... Full text Link to item Cite

Strategies to Identify Patient Risks of Prescription Opioid Addiction When Initiating Opioids for Pain: A Systematic Review.

Journal Article JAMA Netw Open · May 3, 2019 IMPORTANCE: Although prescription opioid use disorder is associated with substantial harms, strategies to identify patients with pain among whom prescription opioids can be safely prescribed have not been systematically reviewed. OBJECTIVE: To review the e ... Full text Link to item Cite

Does This Patient Have a Severe Snake Envenomation?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA Surg · April 1, 2019 IMPORTANCE: Venomous snakebite severity ranges from an asymptomatic dry bite to severe envenomation and death. The clinical evaluation aids in prognosis and is essential to determine the risks and potential benefits of antivenom treatment. OBJECTIVES: To i ... Full text Link to item Cite

Will This Patient Be Difficult to Intubate?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA · February 5, 2019 Importance: Recognizing patients in whom endotracheal intubation is likely to be difficult can help alert physicians to the need for assistance from a clinician with airway training and having advanced airway management equipment available. Objective: To i ... Full text Link to item Cite

Does This Patient Have Acute Mountain Sickness?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA · November 14, 2017 IMPORTANCE: Acute mountain sickness (AMS) affects more than 25% of individuals ascending to 3500 m (11 500 ft) and more than 50% of those above 6000 m (19 700 ft). AMS may progress from nonspecific symptoms to life-threatening high-altitude cerebral edema ... Full text Link to item Cite

Incorrect Data in the Statistical Methods Section

Journal Article JAMA · October 3, 2017 Full text Cite

Does This Child Have Pneumonia?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA · August 1, 2017 IMPORTANCE: Pneumonia is a leading cause of morbidity and mortality in children. It is important to identify the clinical symptoms and physical examination findings associated with pneumonia to improve timely diagnosis, prevent significant morbidity, and l ... Full text Link to item Cite

Childhood Pneumonia.

Journal Article JAMA · August 1, 2017 Full text Link to item Cite

Splenectomy as a Destination: Improving Quality of Care Among Asplenic Veterans Through a Travel Clinic.

Journal Article Am J Med · July 2017 BACKGROUND: Asplenic patients are at risk for severe infections, but adherence to recommended preventive education and vaccination is poor. The goal of this study was to demonstrate that a targeted intervention can improve vaccination rates in a population ... Full text Open Access Link to item Cite

Improving Timely Resident Follow-Up and Communication of Results in Ambulatory Clinics Utilizing a Web-Based Audit and Feedback Module.

Journal Article J Grad Med Educ · April 2017 BACKGROUND: Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barri ... Full text Open Access Link to item Cite

Predicting low testosterone in aging men: a systematic review.

Journal Article CMAJ · September 20, 2016 BACKGROUND: Physicians diagnose and treat suspected hypogonadism in older men by extrapolating from the defined clinical entity of hypogonadism found in younger men. We conducted a systematic review to estimate the accuracy of clinical symptoms and signs f ... Full text Link to item Cite

Guideline-based decision support has a small, non-sustained effect on transthoracic echocardiography ordering frequency.

Journal Article BMJ Qual Saf · January 2016 BACKGROUND: Guidance for appropriate utilisation of transthoracic echocardiograms (TTEs) can be incorporated into ordering prompts, potentially affecting the number of requests. METHODS: We incorporated data from the 2011 Appropriate Use Criteria for Echoc ... Full text Open Access Link to item Cite

Does This Patient With Chest Pain Have Acute Coronary Syndrome?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA · November 10, 2015 IMPORTANCE: About 10% of patients with acute chest pain are ultimately diagnosed with acute coronary syndrome (ACS). Early, accurate estimation of the probability of ACS in these patients using the clinical examination could prevent many hospital admission ... Full text Link to item Cite

WITHDRAWN: Antibiotics for acute maxillary sinusitis in adults.

Journal Article Cochrane Database Syst Rev · October 16, 2015 Currently, two separate Cochrane reviews, ‘Antibiotics for acute maxillary sinusitis in adults’ and ‘Antibiotics for clinically diagnosed acute rhinosinusitis in adults’ describe the effect of antibiotics for acute rhinosinusitis. Although both Cochrane re ... Full text Link to item Cite

Approach to the Patient: History and Physical Examination

Chapter · April 15, 2015 Expert Consult eBook version included with purchase. This enhanced eBook experienceallows you to search all of the text, figures, and references from the book on a variety of devices. ... Cite

Does this adult patient have early HIV infection?: The Rational Clinical Examination systematic review.

Journal Article JAMA · July 16, 2014 IMPORTANCE: Timely identification of human immunodeficiency virus (HIV) infection in adults can contribute to reduced mortality and likelihood of further HIV transmission. During the first 6 months after infection, known as early HIV infection, patients of ... Full text Link to item Cite

Does this patient with shoulder pain have rotator cuff disease?: The Rational Clinical Examination systematic review.

Journal Article JAMA · August 28, 2013 Featured Publication IMPORTANCE: Rotator cuff disease (RCD) is the most common cause of shoulder pain seen by physicians. OBJECTIVE: To perform a meta-analysis to identify the most accurate clinical examination findings for RCD. DATA SOURCES: Structured search in MEDLINE, EMBA ... Full text Link to item Cite

Does this patient have obstructive sleep apnea?: The Rational Clinical Examination systematic review.

Journal Article JAMA · August 21, 2013 Featured Publication IMPORTANCE: Obstructive sleep apnea is a common disease, responsible for daytime sleepiness. Prior to referring patients for definitive testing, the likelihood of obstructive sleep apnea should be established in the clinical examination. OBJECTIVE: To syst ... Full text Link to item Cite

Do findings on routine examination identify patients at risk for primary open-angle glaucoma? The rational clinical examination systematic review.

Journal Article JAMA · May 15, 2013 Featured Publication IMPORTANCE: Glaucoma is the second leading cause of blindness worldwide, and its insidious onset is often associated with diagnostic delay. Since glaucoma progression can often be effectively diminished when treated, identifying individuals at risk for gla ... Full text Link to item Cite

Likelihood ratios, sensitivity, and specificity values can be back-calculated when the odds ratios are known.

Journal Article J Clin Epidemiol · April 2013 Featured Publication OBJECTIVE: To provide a solution for calculating the true-positive, false-positive, false-negative, and true-negative results from studies where only the odds ratios (ORs), number of patients with the finding, and number of patients with the target conditi ... Full text Link to item Cite

Does this adult patient have a blunt intra-abdominal injury?

Journal Article JAMA · April 11, 2012 CONTEXT: Blunt abdominal trauma often presents a substantial diagnostic challenge. Well-informed clinical examination can identify patients who require further diagnostic evaluation for intra-abdominal injuries after blunt abdominal trauma. OBJECTIVE: To s ... Full text Link to item Cite

A meta-analysis and systematic review of computed tomography angiography as a diagnostic triage tool for patients with chest pain presenting to the emergency department.

Journal Article J Nucl Cardiol · April 2012 BACKGROUND: To assess clinical utility of computed tomography angiography (CTA) in the diagnosis of chest pain patients presenting to emergency departments (EDs), we conducted a meta-analysis of CTA in patients with suspected acute coronary syndromes (ACSs ... Full text Link to item Cite

Does this patient with liver disease have cirrhosis?

Journal Article JAMA · February 22, 2012 CONTEXT: Among adult patients with liver disease, the ability to identify those most likely to have cirrhosis noninvasively is challenging. OBJECTIVE: To identify simple clinical indicators that can exclude or detect cirrhosis in adults with known or suspe ... Full text Link to item Cite

Autopsy and grief: a case of transformative postmortem examination.

Journal Article J Palliat Med · February 2012 BACKGROUND: A physician's obligations to deliver compassionate care do not end with a patient's death. When a patient dies there remains a responsibility to assist grieving family members. Unfortunately, many physicians feel ill prepared to assist in the b ... Full text Link to item Cite

Does this patient have malaria?

Journal Article JAMA · November 10, 2010 CONTEXT: Malaria commonly infects residents of and travelers to tropical regions. The clinical features of infection are notoriously nonspecific but have not been comprehensively evaluated. OBJECTIVE: To systematically review and synthesize data related to ... Full text Link to item Cite

Clinical features suggestive of meningitis in children: a systematic review of prospective data.

Journal Article Pediatrics · November 2010 CONTEXT: Clinical diagnosis of pediatric meningitis is fundamental; therefore, familiarity with evidence underscoring clinical features suggestive of meningitis is important. OBJECTIVE: To seek evidence supporting accuracy of clinical features of pediatric ... Full text Link to item Cite

Does this patient have delirium?: value of bedside instruments.

Journal Article JAMA · August 18, 2010 CONTEXT: Delirium occurs in many hospitalized older patients and has serious consequences including increased risk for death and admission to long-term care. Despite its importance, health care clinicians often fail to recognize delirium. Simple bedside in ... Full text Link to item Cite

A comparative resident site visit project: a novel approach for implementing programmatic change in the duty hours era.

Journal Article Acad Med · July 2010 The Duke University Medical Center Internal Medicine Residency Program did not reach its anticipated quota of applicants during the 2008 National Residency Matching Program. Post-Match feedback regarding workload prompted an effort to redesign the general ... Full text Link to item Cite

Meta-analyses of septal reduction therapies for obstructive hypertrophic cardiomyopathy: comparative rates of overall mortality and sudden cardiac death after treatment.

Journal Article Circ Cardiovasc Interv · April 2010 BACKGROUND: Septal reduction for obstructive hypertrophic cardiomyopathy may be performed by surgical myectomy or alcohol septal ablation (ASA). Unlike surgical myectomy, ASA creates an intramyocardial scar that may potentiate the risk of ventricular arrhy ... Full text Link to item Cite

Differences between univariate and bivariate models for summarizing diagnostic accuracy may not be large.

Journal Article J Clin Epidemiol · December 2009 OBJECTIVE: Experts recommend random effects bivariate logitnormal sensitivity and specificity estimates, rather than directly summarized univariate likelihood ratios (LRs) for diagnostic test meta-analyses. We assessed whether bivariate measures might caus ... Full text Link to item Cite

Acute-onset floaters and flashes: is this patient at risk for retinal detachment?

Journal Article JAMA · November 25, 2009 CONTEXT: Acute onset of monocular floaters and/or flashes represents a common presentation to primary care physicians, and the most likely diagnosis is posterior vitreous detachment (PVD). A significant proportion of patients with acute PVD develop an asso ... Full text Link to item Cite

Patient education and provider decision support to control blood pressure in primary care: a cluster randomized trial.

Journal Article Am Heart J · March 2009 BACKGROUND: Less than one third of the 65 million Americans with hypertension have adequate blood pressure (BP) control. This study examined the effectiveness of 2 interventions for improving patient BP control. METHODS: This was a 2-level (primary care pr ... Full text Link to item Cite

Will the history and physical examination help establish that irritable bowel syndrome is causing this patient's lower gastrointestinal tract symptoms?

Journal Article JAMA · October 15, 2008 CONTEXT: Many individuals experience lower gastrointestinal tract symptoms, most commonly attributable to functional conditions. These individuals are frequently diagnosed with irritable bowel syndrome (IBS) based on their symptoms; however, some may requi ... Full text Link to item Cite

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis

Book · August 25, 2008 The ultimate guide to the evidence-based clinical encounter "This book is an excellent source of supported evidence that provides useful and clinically relevant information for the busy practitioner, student, resident, or educator who wants ... ... Cite

The STARD statement for reporting diagnostic accuracy studies: application to the history and physical examination.

Journal Article J Gen Intern Med · June 2008 OBJECTIVE: The Standards for Reporting of Diagnostic Accuracy (STARD) statement provided guidelines for investigators conducting diagnostic accuracy studies. We reviewed each item in the statement for its applicability to clinical examination diagnostic ac ... Full text Link to item Cite

Update: Pneumonia, Infant and Child

Chapter · April 30, 2008 The ultimate guide to the evidence-based clinical encounter "This book is an excellent source of supported evidence that provides useful and clinically relevant information for the busy practitioner, student, resident, or educator who wants ... ... Cite

Overcoming inertia: improvement in achieving target low-density lipoprotein cholesterol.

Journal Article Am J Manag Care · September 2007 OBJECTIVE: To improve lipid management of high-risk patients in a large academic primary care practice. STUDY DESIGN: Educational intervention with historical controls. METHODS: We determined the likelihood of providers within an academic Veterans Affairs ... Link to item Cite

Opiates and Acute Abdominal Pain—Reply

Journal Article JAMA · February 7, 2007 Full text Cite

Intravenous Pyelography

Journal Article · December 1, 2006 Full text Cite

Do opiates affect the clinical evaluation of patients with acute abdominal pain?

Journal Article JAMA · October 11, 2006 Featured Publication CONTEXT: Clinicians have traditionally withheld opiate analgesia from patients with acute abdominal pain until after evaluation by a surgeon, out of concern that analgesia may alter the physical findings and interfere with diagnosis. OBJECTIVE: To determin ... Full text Link to item Cite

Overcoming provider inertia: Improvement in LDL-cholesterol management

Journal Article JOURNAL OF GENERAL INTERNAL MEDICINE · April 1, 2006 Link to item Cite

Time, now, to recover the fun in the physical examination rather than abandon it.

Journal Article Arch Intern Med · March 27, 2006 Featured Publication Full text Link to item Cite

Does the clinical examination predict lower extremity peripheral arterial disease?

Journal Article JAMA · February 1, 2006 Featured Publication CONTEXT: Lower extremity peripheral arterial disease (PAD) is common and associated with significant increases in morbidity and mortality. Physicians typically depend on the clinical examination to identify patients who need further diagnostic testing. OBJ ... Full text Link to item Cite

Effect of an opioid management system on opioid prescribing and unscheduled visits in a large primary care clinic

Journal Article Journal of Clinical Outcomes Management · December 1, 2005 • Objective: To measure the effect of an explicit pain management program on unscheduled patient visits, prescribing behavior, and opioid use. • Design: Retrospective cohort study. • Setting: General medicine practice of a university-affiliated Veterans Af ... Cite

Quantitative myasthenia gravis score: assessment of responsiveness and longitudinal validity.

Journal Article Neurology · June 14, 2005 We prospectively tested the quantitative myasthenia gravis score (QMG) for responsiveness and longitudinal construct validity in 53 patients with myasthenia gravis. Index of responsiveness was high. Longitudinal construct validity was confirmed by the corr ... Full text Link to item Cite

Is this patient having a stroke?

Journal Article JAMA · May 18, 2005 CONTEXT: Patients suspected of having a stroke or transient ischemic attack require accurate assessment for appropriate acute treatment and use of secondary preventive interventions. OBJECTIVE: To update a 1994 systematic review of the accuracy and reliabi ... Full text Link to item Cite

Does this patient have myasthenia gravis?

Journal Article JAMA · April 20, 2005 CONTEXT: Clinicians must be able to diagnose myasthenia gravis, since delays in establishing the diagnosis may put patients at risk for complications from this treatable disease. OBJECTIVE: To determine if items in the history and examination or results of ... Full text Link to item Cite

Does this patient have influenza?

Journal Article JAMA · February 23, 2005 CONTEXT: Influenza vaccination lowers, but does not eliminate, the risk of influenza. Making a reliable, rapid clinical diagnosis is essential to appropriate patient management that may be especially important during shortages of antiviral agents caused by ... Full text Link to item Cite

Intravenous Pyelography

Chapter · January 1, 2005 Full text Cite

Patient and clinician satisfaction with a store-and-forward teledermatology consult system.

Journal Article Telemed J E Health · 2004 The aim of this study was to assess satisfaction with and acceptance of a store and forward teledermatology consult system among patients, referring primary-care clinicians, and consultant dermatologists. As part of a randomized clinical trial that compare ... Full text Link to item Cite

Does this patient have pulmonary embolism?

Journal Article JAMA · December 3, 2003 CONTEXT: Experienced clinicians' gestalt is useful in estimating the pretest probability for pulmonary embolism and is complementary to diagnostic testing, such as lung scanning. However, it is unclear whether recently developed clinical prediction rules, ... Full text Link to item Cite

Does this child have acute otitis media?

Journal Article JAMA · September 24, 2003 Featured Publication CONTEXT: Acute otitis media (AOM) is one of the most common problems in pediatrics. An accurate diagnosis of AOM can guide proper treatment and follow-up. OBJECTIVE: To systematically review the literature regarding precision and accuracy of history taking ... Full text Link to item Cite

Staphylococcus aureus bacteremia after median sternotomy: clinical utility of blood culture results in the identification of postoperative mediastinitis.

Journal Article Circulation · July 8, 2003 BACKGROUND: Mediastinitis is a complication of coronary artery bypass graft surgery (CABG) that can be difficult to diagnose. This study evaluated the utility of blood culture results in identifying patients with mediastinitis. METHODS AND RESULTS: All uni ... Full text Link to item Cite

Antibiotics for acute maxillary sinusitis.

Journal Article Cochrane database of systematic reviews (Online) · 2003 BACKGROUND: For adults seeking care in ambulatory medical practices, sinusitis is the most common diagnosis treated with antibiotics. OBJECTIVES: We examined whether antibiotics are indicated for acute sinusitis, and if so, which antibiotic classes are mos ... Cite

An economic analysis of a store and forward teledermatology consult system.

Journal Article Telemed J E Health · 2003 Our objective was to assess the economic impact of store-and-forward teledermatology in a United States Department of Veterans Affairs (VA) health care setting. Patients being referred to the Dermatology Consult Service from the Primary Care Clinics at the ... Full text Link to item Cite

Antibiotics for acute maxillary sinusitis.

Journal Article Cochrane Database Syst Rev · 2003 BACKGROUND: For adults seeking care in ambulatory medical practices, sinusitis is the most common diagnosis treated with antibiotics. OBJECTIVES: We examined whether antibiotics are indicated for acute sinusitis, and if so, which antibiotic classes are mos ... Full text Link to item Cite

Improving the clinical examination for a low ankle-brachial index

Journal Article International Journal of Angiology · October 16, 2002 We sought to determine clinical examination features that predict an abnormal ankle-brachial index (ABI). Eleven United States and Canadian university-affiliated practices participated. Patients over age 55 (n = 218) presenting for an outpatient appointmen ... Full text Cite

Does this woman have an acute uncomplicated urinary tract infection?

Journal Article JAMA · May 22, 2002 CONTEXT: Symptoms suggestive of acute urinary tract infection (UTI) constitute one of the most common reasons for women to visit clinicians. Although the clinical encounter typically involves taking a history and performing a physical examination, the diag ... Full text Link to item Cite

Teledermatology's impact on time to intervention among referrals to a dermatology consult service.

Journal Article Telemed J E Health · 2002 Featured Publication The aim of this study was to determine if a teledermatology consult system, using store-and-forward digital imaging technology, results in patients achieving a shorter time from referral date to date of initial definitive intervention when compared to a tr ... Full text Link to item Cite

Efficacy of intranasal corticosteroids for acute sinusitis - Reply

Journal Article JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION · 2002 Cite

Comparison of cefuroxime with or without intranasal fluticasone for the treatment of rhinosinusitis. The CAFFS Trial: a randomized controlled trial.

Journal Article JAMA · December 26, 2001 Featured Publication CONTEXT: It is not known whether intranasal corticosteroids are beneficial to treat acute rhinosinusitis in patients with a history of chronic or recurrent sinus symptoms. OBJECTIVE: To assess whether the addition of an intranasal corticosteroid to antibio ... Full text Link to item Cite

The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination.

Journal Article JAMA · October 3, 2001 Featured Publication CONTEXT: While most meniscal or ligamentous knee injuries heal with nonoperative treatments, a subset should be treated with arthroscopic or open surgery. OBJECTIVE: To analyze the accuracy of the clinical examination for meniscal or ligamentous knee injur ... Full text Link to item Cite

Antibiotics for acute maxillary sinusitis

Journal Article Praxis · September 28, 2000 Cite

Antibiotics for acute maxillary sinusitis.

Journal Article Cochrane database of systematic reviews (Online) · 2000 OBJECTIVES: For adults seeking care in ambulatory practices, sinusitis is the most common diagnosis treated with antibiotics. We examined whether antibiotics are indicated for acute sinusitis, and if so, which antibiotic classes are most effective. SEARCH ... Cite

Cranial computed tomography before lumbar puncture: a prospective clinical evaluation.

Journal Article Arch Intern Med · December 13, 1999 Featured Publication OBJECTIVE: To prospectively identify which patients can safely undergo lumbar puncture (LP) without screening cranial computed tomography (CT). METHODS: Emergency department physicians examined patients before CT. Examiners recorded the presence or absence ... Full text Link to item Cite

Reliability and accuracy of dermatologists' clinic-based and digital image consultations.

Journal Article J Am Acad Dermatol · November 1999 BACKGROUND: Telemedicine technology holds great promise for dermatologic health care delivery. However, the clinical outcomes of digital image consultations (teledermatology) must be compared with traditional clinic-based consultations. OBJECTIVE: Our purp ... Full text Link to item Cite

Review: Physical signs are not useful for detecting non-blood-loss hypovolemia

Journal Article Evidence Based Medicine · September 1, 1999 Cite

Clinical examination for the detection of protective sensation in the feet of diabetic patients. International Cooperative Group for Clinical Examination Research.

Journal Article J Gen Intern Med · July 1999 OBJECTIVE: We compared the reproducibility and accuracy of conventional clinical examination of the diabetic foot to monofilament examination. We also sought to simplify the monofilament examination by reducing it to fewer touch points. METHODS: In a cross ... Full text Link to item Cite

Hormone replacement therapy and the risk of colorectal cancer: a meta-analysis.

Journal Article Obstet Gynecol · May 1999 OBJECTIVE: To review systematically the association between hormone replacement therapy (HRT) and the risk of developing or dying from colorectal cancer. DATA SOURCES: We searched the English-language literature using MEDLINE, Current Contents, CancerLit, ... Full text Link to item Cite

The rational clinical examination. Is this patient hypovolemic?

Journal Article JAMA · March 17, 1999 OBJECTIVE: To review, systematically, the physical diagnosis of hypovolemia in adults. METHODS: We searched MEDLINE (January 1966-November 1997), personal files, and bibliographies of textbooks on physical diagnosis and identified 10 studies investigating ... Full text Link to item Cite

The rational clinical examination. Does this patient have abdominal aortic aneurysm?

Journal Article JAMA · January 6, 1999 In the physical examination of abdominal aortic aneurysm (AAA), the only maneuver of demonstrated value is abdominal palpation to detect abnormal widening of the aortic pulsation. Palpation of AAA appears to be safe and has not been reported to precipitate ... Full text Link to item Cite

Reliability and accuracy of dermatologists' digital image consultations

Journal Article Journal of Investigative Medicine · January 1, 1999 We compared the reliability and accuracy of diagnoses and management plans generated by dermatologists performing digital image review with dermatologists performing traditional clinic-based consultations. Our patient sample included referrals to a dermato ... Cite

A report on my headaches.

Journal Article N C Med J · 1999 Link to item Cite

The rational clinical examination. Is this patient having a myocardial infarction?

Journal Article JAMA · October 14, 1998 When faced with a patient with acute chest pain, clinicians must distinguish myocardial infarction (MI) from all other causes of acute chest pain. If MI is suspected, current therapeutic practice includes deciding whether to administer thrombolysis or prim ... Full text Link to item Cite

Hormone replacement therapy and the risk of colorectal cancer: a meta-analysis.

Journal Article Prim Care Update Ob Gyns · July 1, 1998 Objective: To review systematically the association between hormone replacement therapy and colorectal cancer incidence and mortality.Methods: We conducted a literature search of English-language studies using MEDLINE, Current Contents, CancerLit, and bibl ... Full text Link to item Cite

A pilot trial of digital imaging in skin cancer.

Journal Article J Telemed Telecare · 1998 We have used inexpensive off-the-shelf equipment for store-and-forward teledermatology and compared the precision and accuracy of digital image consultations with conventional, clinic-based consultations. Thirteen lesions were studied on 12 patients referr ... Full text Link to item Cite

The development of a primary care curriculum for obstetrics/gynecology residents.

Journal Article J Am Med Womens Assoc (1972) · 1998 In order to develop a primary care curriculum for obstetricians and gynecologists, a needs assessment was performed to determine those topics in which additional training was needed. We used a Likert scale comfort score (0-10) for evaluating or treating 14 ... Link to item Cite

Diagnostic efficiency of home pregnancy test kits. A meta-analysis.

Journal Article Arch Fam Med · 1998 OBJECTIVE: To assess the diagnostic efficiency of home pregnancy test (HPT) kits. DATA SOURCES: A literature search of English-language studies was performed with MEDLINE and a review of bibliographies. STUDY SELECTION: Studies were included if HPT kits we ... Full text Link to item Cite

[Improving the quality of reports on randomized controlled trials. Recommendations of the CONSORT Study Group].

Journal Article Rev Esp Salud Publica · 1998 This summary corresponds to the translation into Spanish of the Special Communication published in the Journal of the American Medical Association in August 1996, along with the editorial published in the same issue "How to report Randomized Controlled Tri ... Link to item Cite

Quantitative assessments from the clinical examination - In reply

Journal Article JOURNAL OF GENERAL INTERNAL MEDICINE · August 1, 1997 Link to item Cite

Primary care clinicians' performance for detecting actinic keratoses and skin cancer.

Journal Article Arch Intern Med · May 12, 1997 BACKGROUND: If skin cancer screening is to become widely adopted, its effectiveness depends on the ability of primary care clinicians to detect cutaneous malignancies. OBJECTIVE: To assess primary care clinicians' proficiency for detecting skin cancers and ... Link to item Cite

Quantitative assessments from the clinical examination. How should clinicians integrate the numerous results?

Journal Article J Gen Intern Med · March 1997 OBJECTIVE: To describe strategies for using multiple clinical examination items to estimate disease probabilities; and to evaluate the diagnostic accuracy of each strategy. DESIGN: Prospective observational study. SETTING: Medical preoperative evaluation c ... Full text Link to item Cite

Smoking behavior on the first day of a quit attempt predicts long-term abstinence.

Journal Article Arch Intern Med · February 10, 1997 BACKGROUND: The nicotine patch has been widely used for smoking cessation, but not all smokers quit using the patch. Knowing which smokers are likely to succeed with the nicotine patch may improve the efficiency of nicotine patch use. OBJECTIVE: To identif ... Link to item Cite

Can a summary laboratory score predict health status and inpatient utilization

Journal Article Drug Information Journal · 1996 The Genie score is a summary laboratory score derived from the average of a patient's deviations from specified normal laboratory values. The ability of the Genie score to predict important inpatient resource use, functional status, and patient comorbidity ... Cite

Prevalence of patients at risk for oropharyngeal cancer in veterans affairs dental clinic

Journal Article Journal of Investigative Medicine · January 1, 1996 Screening for oropharyngeal cancer is recommended for patients considered at risk (patients over 40, and users of tobacco or alcohol). Previous studies also indicate that the presence of an oral symptom predicts malignancy. We surveyed 389 consecutive pati ... Cite

A randomized clinical trial comparing ibuprofen to piroxicam for the relief of chronic non-rheumatic joint pain

Journal Article Journal of Investigative Medicine · January 1, 1996 Nonsteroidal antiinflammatory agents (NSAIDs) demonstrate similar efficacy for chronic joint pain, however they are not equally affordable. We assessed whether patients who preferred a more expensive NSAID, i.e. piroxicam, had better pain relief on this dr ... Cite

Primary care clinicians' performance in the diagnosis of actinic keratoses and skin cancer

Journal Article Journal of Investigative Medicine · January 1, 1996 If skin cancer screening is to become widely adopted, increasing its accessibility would be best achieved by incorporating screening examinations into routine patient care by primary care clinicians (PCCs). Because PCCs' proficiency for detecting skin canc ... Cite

The influence of history on interobserver agreement for diagnosing actinic keratoses and malignant skin lesions.

Journal Article J Am Acad Dermatol · October 1995 BACKGROUND: Quantifying interobserver diagnostic agreement is necessary to evaluate skin cancer screening programs, but estimates of variability are incomplete. OBJECTIVE: We sought to measure agreement between dermatologists for diagnosing actinic keratos ... Full text Link to item Cite

Cytologic screening after hysterectomy for benign disease.

Journal Article Am J Obstet Gynecol · August 1995 OBJECTIVE: Our purpose was to determine the effectiveness of vaginal cytology tests after hysterectomy for benign disease. STUDY DESIGN: We studied a 10-year retrospective cohort of patients after hysterectomy (n = 697 women, 9074 woman years). Patients we ... Full text Link to item Cite

Measuring activities in clinical trials using random work sampling: implications for cost-effectiveness analysis and measurement of the intervention.

Journal Article J Clin Epidemiol · August 1995 Determining research-related costs from intervention-related costs is important for both clinical and health services research. Often this task involves estimating what proportion of the workday personnel spend on a variety of activities. We used a portabl ... Full text Link to item Cite

DOES THE CLINICAL EXAMINATION PREDICT AIR-FLOW LIMITATION (VOL 273, PG 313, 1995)

Journal Article JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION · May 3, 1995 Link to item Cite

Randomized controlled trial of 3 vs 10 days of trimethoprim/sulfamethoxazole for acute maxillary sinusitis.

Journal Article JAMA · April 5, 1995 OBJECTIVE: To compare 14-day outcomes and relapse and recurrence rates among patients with acute maxillary sinusitis randomized to 3-day (3D) vs 10-day (10D) treatment with trimethoprim/sulfamethoxazole (TMP/SMX). SETTING: University-affiliated Veterans Af ... Link to item Cite

Measuring shoulder function with the Shoulder Pain and Disability Index.

Journal Article J Rheumatol · April 1995 OBJECTIVE: To extend the validity of the Shoulder Pain and Disability Index (SPADI) by (1) making it suitable for telephone administration; (2) determining its convergent validity with other health status measures; and (3) assessing the responsiveness of t ... Link to item Cite

Usual care and outcomes in patients with sinus complaints and normal results of sinus roentgenography.

Journal Article Arch Fam Med · March 1995 OBJECTIVE: To describe the usual care and outcomes of patients with sinus symptoms and normal sinus roentgenograms. DESIGN: Prospective cohort with 60-day follow-up. SETTING: Medical outpatient clinics at a university-affiliated Veterans Affairs medical ce ... Full text Link to item Cite

Noninvasive carotid artery testing. A meta-analytic review.

Journal Article Ann Intern Med · March 1, 1995 PURPOSE: To compare the operating characteristics of six noninvasive tests for carotid artery stenosis. DATA SOURCES: A structured search was done using MEDLINE, reference lists from selected articles, and bibliographies from neurology textbooks that focus ... Full text Link to item Cite

A nurse-coordinated intervention for primary care patients with non-insulin-dependent diabetes mellitus: impact on glycemic control and health-related quality of life.

Journal Article J Gen Intern Med · February 1995 OBJECTIVE: To examine the impact of a nurse-coordinated intervention delivered to patients with non-insulin-dependent diabetes mellitus between office visits to primary care physicians. DESIGN: Randomized, controlled trial. SETTING: Veterans Affairs genera ... Full text Link to item Cite

The relationship between glycemic control and health-related quality of life in patients with non-insulin-dependent diabetes mellitus.

Journal Article Med Care · December 1994 The relationship between glycemic control and health-related quality of life was examined in patients with non-insulin-dependent diabetes mellitus (NIDDM). Within the context of a randomized controlled trial, 275 patients with NIDDM receiving primary care ... Full text Link to item Cite

UNTITLED

Journal Article HEALTH SERVICES RESEARCH · December 1, 1994 Link to item Cite

Should physicians screen for oral disease? A physical examination study of the oral cavity.

Journal Article J Gen Intern Med · October 1994 OBJECTIVE: To assess how well primary care clinicians select patients needing early referral to a dentist based on an oral cavity examination. DESIGN: Prospective comparison of the screening oral cavity examinations performed by primary care clinicians wit ... Full text Link to item Cite

A telephone-delivered intervention for patients with NIDDM. Effect on coronary risk factors.

Journal Article Diabetes Care · August 1994 OBJECTIVE: To examine whether a telephone-delivered intervention (TDI), designed to improve glycemic control in patients with non-insulin-dependent diabetes mellitus (NIDDM), improved coronary risk factors in high-risk patients. RESEARCH DESIGN AND METHODS ... Full text Link to item Cite

Time analysis of a general medicine service: results from a random work sampling study.

Journal Article J Gen Intern Med · May 1994 OBJECTIVE: To describe a novel method of time analysis for health care settings by quantifying internal medicine housestaff's work activities and contacts. DESIGN: Observational work sampling study based on random sampling technique. SETTING: General medic ... Full text Link to item Cite

In Reply

Journal Article JAMA the Journal of the American Medical Association · February 16, 1994 Full text Cite

DOES THIS PATIENT HAVE SINUSITIS - REPLY

Journal Article JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION · February 16, 1994 Link to item Cite

Granulocyte deformability and F-actin content: relationship to diabetes mellitus and retinopathy.

Journal Article Am J Med Sci · February 1994 Capillary closure in diabetic retinopathy may be initiated by lumenal occlusion by granulocytes. To determine whether subjects with diabetes mellitus have less deformable granulocytes than healthy subjects, granulocyte deformability was measured by mean en ... Full text Link to item Cite

Comparison of housestaff's estimates of their workday activities with results of a random work-sampling study.

Journal Article Acad Med · November 1993 BACKGROUND: Accurately quantifying housestaff's workday activities is acquiring increasing importance as resources become constrained and programs become more accountable for medical education. The authors compared a traditional method of time analysis bas ... Link to item Cite

Smokeless tobacco use in an outpatient veteran population.

Journal Article South Med J · August 1993 Smokeless tobacco use is a significant health risk for carcinoma of the oropharynx, and has a high prevalence in the southern United States. To evaluate the potential demand for a smokeless tobacco cessation program, we surveyed patients attending the Gene ... Full text Link to item Cite

General internal medicine.

Journal Article JAMA · July 14, 1993 Link to item Cite

Diagnosing sinusitis.

Journal Article Ann Intern Med · July 1, 1993 Full text Link to item Cite

Diagnosing Sinusitis

Journal Article Annals of Internal Medicine · July 1, 1993 Full text Cite

The effect of sleeved arms on oscillometric blood pressure measurement.

Journal Article J Gen Intern Med · June 1993 The authors measured the blood pressures of 36 subjects who had bare and sleeved arms to determine the effect of wearing sleeves on automatic oscillometric blood pressure measurements. They found no statistically significant effect of sleeves on the measur ... Full text Link to item Cite

PHYSICAL DIAGNOSIS COURSES - A SURVEY OF COORDINATORS

Journal Article CLINICAL RESEARCH · April 1, 1993 Link to item Cite

Diagnosis of obstructive airways disease from the clinical examination.

Journal Article J Gen Intern Med · February 1993 OBJECTIVE: To determine the operating characteristics of history and physical examination items for pulmonary airflow obstruction. DESIGN: Prospective observational study. SETTING: Medical Preoperative Evaluation Clinic at the Durham Veterans Affairs Medic ... Full text Link to item Cite

Likelihood ratios for continuous test results--making the clinicians' job easier or harder?

Journal Article J Clin Epidemiol · January 1993 Clinicians' paradigms for considering diagnostic test results require decisions based on the actual test value. However, when the test result is reported on a continuous scale each possible outcome may not result in unique actions. To simplify decision mak ... Full text Link to item Cite

Correction for likelihood-ratio formula

Journal Article Journal of Clinical Epidemiology · January 1, 1993 Full text Cite

Clinical evaluation for sinusitis. Making the diagnosis by history and physical examination.

Journal Article Ann Intern Med · November 1, 1992 OBJECTIVE: To identify the most useful clinical examination findings for the diagnosis of acute and subacute sinusitis. DESIGN: Prospective comparison of clinical findings with radiographs. SETTING: General medicine clinics at a university-affiliated Veter ... Full text Link to item Cite

In Reply

Journal Article JAMA the Journal of the American Medical Association · October 28, 1992 Full text Cite

Suspended judgment. Clinical trials of informed consent.

Journal Article Control Clin Trials · October 1992 Full text Link to item Cite

Diagnosing sinusitis by X-ray: is a single Waters view adequate?

Journal Article J Gen Intern Med · 1992 OBJECTIVE: To determine whether a single Waters view (occipito-mental) radiograph could be substituted for a four-view sinus series to diagnose sinusitis, and to determine the inter- and intraobserver variabilities for sinus radiography. DESIGN: Radiograph ... Full text Link to item Cite

Response

Journal Article Journal of Clinical Epidemiology · January 1, 1992 Full text Cite

MEDICAL WASTE-DISPOSAL IN THE HOME CARE SETTING

Journal Article JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · August 1, 1991 Link to item Cite

PREOPERATIVE DIAGNOSIS OF OBSTRUCTIVE PULMONARY-DISEASE

Journal Article CLINICAL RESEARCH · April 1, 1991 Link to item Cite

PREOPERATIVE SCREENING FOR PULMONARY AIR-FLOW LIMITATION

Journal Article CLINICAL RESEARCH · April 1, 1991 Link to item Cite

A PREDICTIVE MODEL OF PREOPERATIVE LENGTH OF STAY

Journal Article CLINICAL RESEARCH · April 1, 1991 Link to item Cite

PAIN DESCRIPTIONS IN PATIENTS WITH CHRONIC LOW-BACK-PAIN

Journal Article CLINICAL RESEARCH · April 1, 1991 Link to item Cite

LACK OF SEASONAL VARIABILITY FOR ACUTE AND SUBACUTE SINUSITIS

Journal Article CLINICAL RESEARCH · April 1, 1991 Link to item Cite

CLINICAL CHARACTERISTICS OF PATIENTS WITH CHRONIC LOW-BACK-PAIN

Journal Article CLINICAL RESEARCH · April 1, 1991 Link to item Cite

Anti-inflammatory effects of pentoxifylline in claudication.

Journal Article Am J Med Sci · February 1991 We measured neutrophil elastase/alpha 1 proteinase inhibitor complex (E/alpha) levels by ELISA in plasma samples drawn from 19 patients with claudication, before and at 1 and 2 months after initiation of pentoxifylline (PTF), 400 mg. p.o. tid. Plasma E/alp ... Full text Link to item Cite

A randomized controlled trial comparing quantitative informed consent formats.

Journal Article J Clin Epidemiol · 1991 Informed consent has been indirectly studied only in settings that do not replicate the actual consent process. We designed a sham study and randomly allocated adult ambulatory patients to receive one of two consent forms: Consent A (n = 52) described a ra ... Full text Link to item Cite

Likelihood ratios with confidence: sample size estimation for diagnostic test studies.

Journal Article J Clin Epidemiol · 1991 Confidence intervals are important summary measures that provide useful information from clinical investigations, especially when comparing data from different populations or sites. Studies of a diagnostic test should include both point estimates and confi ... Full text Link to item Cite

PREOPERATIVE DIAGNOSIS OF OBSTRUCTIVE PULMONARY-DISEASE

Journal Article CLINICAL RESEARCH · December 1, 1990 Link to item Cite

A PREDICTIVE MODEL OF PREOPERATIVE LENGTH OF STAY

Journal Article CLINICAL RESEARCH · December 1, 1990 Link to item Cite

Effects of pentoxifylline administration on blood viscosity and leukocyte cytoskeletal function in patients with intermittent claudication.

Journal Article J Lab Clin Med · June 1990 We have previously shown that pentoxifylline, a drug used in intermittent claudication, causes depolymerization of actin in leukocytes in vitro. In this study we evaluated several parameters in peripheral blood obtained from 17 patients receiving pentoxify ... Link to item Cite

Superficial migratory thrombophlebitis and factor XII deficiency.

Journal Article J Am Acad Dermatol · May 1990 A patient with painful migratory erythematous nodules for 7 years is presented. The nodules, which were localized on the lower and upper extremities, progressed to palpable cords. Multiple venograms showed no evidence of deep vein thrombosis. Skin biopsy s ... Full text Link to item Cite

Driving-impaired patients leaving the emergency department. The problem of inadequate instructions.

Journal Article Ann Intern Med · March 1, 1990 STUDY OBJECTIVE: We evaluated the frequency with which blood alcohol concentrations were obtained in emergency department patients with presumed alcohol impairment, whether physicians counseled impaired patients not to drive, and whether safe transportatio ... Full text Link to item Cite

A Bayesian method for evaluating medical test operating characteristics when some patients' conditions fail to be diagnosed by the reference standard.

Journal Article Med Decis Making · 1990 The evaluation of a diagnostic test when the reference standard fails to establish a diagnosis in some patients is a common and difficult analytical problem. Conventional operating characteristics, derived from a 2 x 2 matrix, require that tests have only ... Full text Link to item Cite

Uniform Priors Aren't a Thing of the Past

Journal Article Medical Decision Making · January 1, 1990 Full text Cite

Intravenous pyelography before hysterectomy.

Journal Article Ann Intern Med · September 15, 1989 Full text Link to item Cite

Does determining serum alcohol concentrations in emergency department patients influence physicians' civil suit liability?

Journal Article Arch Intern Med · May 1989 Emergency physicians may incur liability when impaired patients who have been treated and released are subsequently involved in traffic crashes. We surveyed attorneys to assess their perception of how serum alcohol determinations might influence their liab ... Link to item Cite

Blood alcohol measurements in the emergency department: who needs them?

Journal Article Am J Public Health · November 1988 We surveyed North Carolina emergency physicians to determine current medical practices regarding the use of blood alcohol concentrations using a hypothetical scenario. Most physicians (88 per cent) would not have obtained blood alcohol concentrations in a ... Full text Link to item Cite

Left arm pain isn't always angina.

Journal Article N C Med J · November 1988 Link to item Cite

Routine intravenous pyelograms before hysterectomy in cases of benign disease: possibly effective, definitely expensive.

Journal Article Am J Obstet Gynecol · November 1988 Intraoperative ureteral injuries are potentially serious iatrogenic complications. Routine preoperative intravenous pyelograms might decrease the risk of such injuries during hysterectomy in cases of nonmalignant disease, but no prospective studies have be ... Full text Link to item Cite

Erythrocyte anisocytosis. Visual inspection of blood films vs automated analysis of red blood cell distribution width.

Journal Article Arch Intern Med · April 1988 An improved anemia classification may be available by combining measures of red blood cell size variability with mean corpuscular volume. Visual inspection of the peripheral blood film allows semiquantitative description of anisocytosis while quantitative ... Full text Link to item Cite

Does maternal platelet-associated or platelet-bindable IgG correlate with levels in umbilical cord blood or colostrum during normal pregnancy?

Journal Article Am J Obstet Gynecol · February 1988 Existing data regarding the ability to predict neonatal thrombocytopenia during maternal immune thrombocytopenia are confusing. We studied normal pregnancies (n = 20) to define normal values and the correlation between maternal and umbilical cord platelet ... Full text Link to item Cite

Does lacrimal duct occlusion decrease intraocular pressure in patients refractory to medical treatment for glaucoma? A randomized, sham-controlled, crossover trial.

Journal Article J Clin Epidemiol · 1988 We temporarily occluded lacrimal ducts with dissolvable collagen inserts in a randomized, double masked, sham-controlled crossover trial to test whether longer ocular contact of eye drops lowers intraocular pressure in patients with refractory glaucoma. Pa ... Full text Link to item Cite

Quantitating bedside diagnosis: clinical evaluation of ascites.

Journal Article J Gen Intern Med · 1988 The authors prospectively evaluated the operating characteristics of the history and physical examination for ascites in a broad spectrum of hospitalized patients. The overall clinical evaluation produced a positive likelihood ratio = 37.7-83.3 when sugges ... Full text Link to item Cite

ARE ROUTINE PRE-HYSTERECTOMY IVPS COST-EFFECTIVE

Journal Article CLINICAL RESEARCH · January 1, 1988 Link to item Cite

Arsenic poisoning and seizures.

Journal Article N C Med J · December 1987 Link to item Cite

Correction of hypoprothrombinemia by immunosuppressive treatment of the lupus anticoagulant-hypoprothrombinemia syndrome.

Journal Article Am J Med · September 1987 A 66-year-old man with the lupus anticoagulant-hypoprothrombinemia syndrome was treated with cyclophosphamide and prednisone to correct a factor II deficiency prior to elective major surgery. Whereas the lupus anticoagulant activity persisted, functional f ... Full text Link to item Cite

Quantitative approaches to clinical diagnosis of cancer in elderly patients.

Journal Article Clin Geriatr Med · August 1987 Recommendations for cancer detection in the elderly are based on even less evidence of efficacy than are recommendations for the general adult population. In this article, we present some quantitative measures of test performance--operating characteristics ... Link to item Cite

Cold hemagglutinin disease in the operating room.

Journal Article South Med J · April 1987 Cold hemagglutinin disease is infrequently recognized before complications ensue. We describe a patient with chronic cold hemagglutinin disease who sustained an acute hemolytic crisis during a routine operative procedure in a cool operating room. Cold aggl ... Full text Link to item Cite

Who should have intravenous pyelograms before hysterectomy for benign disease?

Journal Article Obstet Gynecol · April 1987 A review of 493 cases was undertaken to identify which patients undergoing hysterectomy for benign disease had received a preoperative intravenous pyelogram (IVP), an abnormality identified by IVP, and intraoperative ureteral injuries. Intravenous pyelogra ... Link to item Cite

Intermediate, indeterminate, and uninterpretable diagnostic test results.

Journal Article Med Decis Making · 1987 Diagnostic tests do not always yield positive or negative results; sometimes the results are intermediate, indeterminate, or uninterpretable. No consensus exists for the incorporation of such results into data assessment. Conventional Bayesian analysis lea ... Full text Link to item Cite

PHYSICAL DIAGNOSIS IS USEFUL IN THE DETECTION OF ASCITES

Journal Article CLINICAL RESEARCH · April 1, 1986 Link to item Cite

PHYSICAL DIAGNOSIS IS USEFUL IN THE CLINICAL DETECTION OF ASCITES

Journal Article CLINICAL RESEARCH · January 1, 1986 Link to item Cite

Leukemic ascites complicating acute myelomonoblastic leukemia.

Journal Article Arch Pathol Lab Med · April 1985 We describe a patient with acute myelomonoblastic leukemia, jaundice, and ascites. The ascitic fluid contained leukemic cells comparable with those of the blood and bone marrow. Treatment with cytarabine (cytosine arabinoside) caused a decrease in the peri ... Link to item Cite

Playing the odds.

Journal Article Lancet · February 9, 1985 Full text Link to item Cite

Is streptokinase safe during menses?

Journal Article Arch Intern Med · April 1984 We used intravenous streptokinase to treat a young woman with deep venous thrombosis manifested during her menses. There was no increase in menstrual bleeding, and she was symptom free six months later. Because menstrual endothelium after the first day of ... Link to item Cite

Scanning electron microscopic study of the airways in normal children and in patients with cystic fibrosis and other lung diseases.

Journal Article Pediatr Pathol · 1984 Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used to examine pulmonary tissue from 9 patients with cystic fibrosis (CF), 12 patients with diseases other than CF, and from two surgically resected specimens with no known ... Full text Link to item Cite

The prevalence of abnormal cilia in normal pediatric lungs.

Journal Article Arch Pathol Lab Med · October 1981 Abnormal respiratory cells have been reported in cases of chronic pediatric respiratory infection. In some cases, there is a specific defect of most cilia, but in others there is a variety of derangements of the architecture of only a fraction of the cilia ... Link to item Cite

ABNORMAL CILIA IN NORMAL PEDIATRIC LUNGS

Journal Article LABORATORY INVESTIGATION · January 1, 1981 Link to item Cite

Managing Spleens

Journal Article Archives of Internal Medicine · January 1, 1980 Full text Cite