DIAGNOSTIC-ACCURACY AND PRECISION IN ASSESSING DERMATOLOGICAL DISEASE- PROBLEM OR PROMISE

Although the clinical examination is important in all medical specialt ies, it is a critical element in the practice of dermatology. Virtuall y all dermatologic conditions are accessible for examination by visual inspection, and the clinical examination is often the sole diagnostic test obtained for directing the patient's care and therapy. A princip al doctrine of dermatology and the entire practice of medicine is the importance of the clinical examination in formulating diagnoses and ma nagement plans. Too often, however, little is known regarding the true value of the clinical examination. Despite being the most accessible and used diagnostic test, the consistency and accuracy of the clinical examination are often not known. The concept of the clinical examinat ion as a diagnostic test that can be described and evaluated in terms of its performance characteristics is a concept that is not familiar t o all physicians. However, the clinical examination can and should be assessed as a diagnostic test. Performance characteristics for more ty pical diagnostic tests, such as clinical pathology specimens and radio graphic procedures, are described, and the same analysis can be perfor med for the clinical examination.