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

Featured Works

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

Journal article JAMA · August 28, 2013 Featured Work 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 Work 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 Work 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 Work 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

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

Journal article JAMA · October 11, 2006 Featured Work 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

Does the clinical examination predict lower extremity peripheral arterial disease?

Journal article JAMA · February 1, 2006 Featured Work 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

Does this child have acute otitis media?

Journal article JAMA · September 24, 2003 Featured Work 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

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

Journal article Telemed J E Health · 2002 Featured Work 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

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 Work 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 Work 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

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

Journal article Arch Intern Med · December 13, 1999 Featured Work 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