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Beauty is in the eye of the examiner: reaching agreement about physical signs and their value


  • Funding: None

    Potential conflicts of interest: No author declares any competing interest in the publication of this article.

Correspondence to: Dr Anthony Joshua, Princess Margaret Hospital, 610 University Avenue, Toronto, M5G 2M9, Canada. Email:



Despite advances in other areas, evidence-based medicine is yet to make substantial inroads on the standard medical physical examination. We have reviewed the evidence about the accuracy and reliability of the physical examination and common clinical signs. The physical examination includes many signs of marginal accuracy and reproducibility. These may not be appreciated by clinicians and could adversely affect decisions about treatment and investigations or the teaching and examination of students and doctors-in-training. We provide a selected summary of the reliability and accuracy as well as important messages of key findings in the physical examination. (Intern Med J 2005; 35: 178–187)