Accuracy of anemia diagnosis by physical examination

Abstract

Context and Objectives: Quantification of clinical signs such as the presence or absence of pallor at clinical examination is a key step for ate two methods for anemia diagnosis by physical examination four-level evaluation (crosses method: +/++/+++/++++] and estimated hemoglobin values, both performed by medical students and staff physicians; and secondly, to investigate whether there was any improvement of years in clinical practice. Design and Setting: Fourty-four randomly selected physicians and medical students in a tertiary care teaching hospital completed a physical examinations on five patients with mild to severe anemia. Methods: The observers used four-level evaluation and also predicted the hemoglobin level. Both methods were compared with the real hemoglobin value as the gold standard. Results: The mean estimated hemoglobin value correlated better with the real hemoglobin values than did the four-level evaluation methods, for offending physicians, residents and students (Spearman's correlation coefficients, respectiveley: 1.0, 1.0 and 0.9 for gressed hemoglobin and 0.8, 0.8 and 0.7 for the four-level evaluation "guessed" hemoglobin values from offending the correlation between guessed hemoglobin value and the four-level method was positive for offending physicians, thus suggesting some kind of improvement with time(p - 0.04). Conclusions: This study showed that estimated hemoglobin was more accurate than evaluation by the four-level method. The number of years in clinical practice did not improve the accuracy of clinical examination for anemia. Copyright © 2007, Associação Paulista de Medicina.