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Scientific Methodology in Clinical Medicine

1964; American College of Physicians; Volume: 61; Issue: 6 Linguagem: Inglês

10.7326/0003-4819-61-6-1162

1539-3704

Alvan R. Feinstein,

Clinical Reasoning and Diagnostic Skills

Special Article1 December 1964Scientific Methodology in Clinical MedicineIV. Acquisition of Clinical DataALVAN R. FEINSTEIN, M.D., F.A.C.P.ALVAN R. FEINSTEIN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-6-1162 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe following paper is the last of four parts of Dr. Feinstein's cogent analysis of scientific methodology in clinical science. The preceding parts appeared in the September, October, and November issues of the ANNALS.—Ed.OUTLINE OF CONTENTS: PART IVINTRODUCTIONIMPROVEMENT OF ART HISTORY TAKING PHYSICAL EXAMINATIONConcern for the PatientFocus and Emphasis in TeachingIMPROVEMENT OF SCIENCEOBJECTIVITYHistory TakingPhysical ExaminationPRECISIONCommunicationHistory TakingPhysical ExaminationSpecificationHistory TakingPhysical ExaminationCONSISTENCYUNIFORMITYHistory TakingPhysical ExaminationRELIABILITYHistory TakingPhysical ExaminationTHE DOMAIN OF THE INVESTIGATIVE CLINICIANSUMMARYEPILOGUEINTRODUCTIONThe traditional dispute whether clinical...References1. FEINSTEIN AR: Scientific methodology in clinical medicine. I. Introduction, principles, and concepts. Ann. Intern. Med. 61: 564, 1964. LinkGoogle Scholar2. FEINSTEIN AR: II. Classification of human disease by clinical behavior. Ibid., p. 757. Google Scholar3. FEINSTEIN AR: III. Evaluation of therapeutic response. Ibid., p. 944. Google Scholar4. ANONYMOUS SOURCE: (Despite an extensive bibliographic search, the author cannot now recall where he read, heard, or overheard this statement.) Google Scholar5. BUTTERWORTHREPPERT JSEH: Auscultatory acumen in the general population. J. Amer. Med. Ass. 174: 32, 1960. CrossrefGoogle Scholar6. MCKUSICK VA: Cardiovascular Sound in Health and Disease, Williams and Wilkins Co., Baltimore, 1958. Google Scholar7. BRUNS DL: A general theory of the causes of murmurs in the cardiovascular system. Amer. J. Med. 27: 360, 1959. CrossrefMedlineGoogle Scholar8. FEINSTEIN AR: Standards, stethoscopes, steroids and statistics. The problem of evaluating treatment in acute rheumatic fever. Pediatrics 27: 819, 1961. MedlineGoogle Scholar9. FEINSTEINWOODSPAGNUOLOTARANTAJONASKLEINBERGTURSKY ARHFMASEE: Rheumatic fever in children and adolescents: A long-term epidemiologic study of subsequent prophylaxis, streptococcal infections, and clinical sequelae. VII. Cardiac changes and sequelae. Ann. Intern. Med. 60: (Supp. 5) 87, 1964. LinkGoogle Scholar10. JONES TD: The diagnosis of rheumatic fever. J. Amer. Med. Ass. 126: 481, 1944. CrossrefGoogle Scholar11. : Report of committee on standards and criteria for programs of care of the council on rheumatic fever: Jones criteria (modified) for guidance in diagnosis of rheumatic fever. Circulation 13: 617, 1956. CrossrefMedlineGoogle Scholar12. FEINSTEINSPAGNUOLO ARM: The clinical patterns of acute rheumatic fever: a reappraisal. Medicine 41: 279, 1962. CrossrefMedlineGoogle Scholar13. ROPESBENNETTCOBBJACOXJESSAR MWGASRRA: 1958 revision of diagnostic criteria for rheumatoid arthritis. Arthritis Rheum. 2: 16, 1959. CrossrefMedlineGoogle Scholar14. SEEGALWERTHEIM DAR: On the failure to supervise students' performance of complete physical examinations. J. Amer. Med. Ass. 180: 476, 1962. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New Haven, ConnecticutFrom the Department of Medicine (Clinical Biostatistics Section), Veterans Administration Hospital, West Haven, Conn., and the Department of Medicine, Yale University School of Medicine, New Haven, Conn.This work was supported in part by a teaching grant from the Lillia Babbitt Hyde Foundation.Requests for reprints should be addressed to Al van R. Feinstein, M.D., Associate Professor of Medicine, Yale University School of Medicine, 333 Cedar St., New Haven, Conn. 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