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Clinical
Assessment of the
Collaborative Studies of the Accuracy and
Precision of the Clinical Examination |
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The (PREOP3-AAI) study has begun and will conclude September 1, 2005. |
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CARE-COAD3 has been completed and the manuscript is currently in preparation. |
We value all of our CARE members. Please help us find the contact information for these missing CARE members.
As you know from the Rational Clinical Examination Series in JAMA1, the all-too-common study of the accuracy and precision of the clinical examination comprises 4 experts examining 40 patients, the latter selected to confirm the biases and reputations of the former. The pioneering work of the US-Canadian Co-operative Research Group on the Clinical Exam reversed this trend, but even it has faced formidable problems in participation rates and patient numbers.
A group of Canadians2 who began this work at the NHS R&D Centre for Evidence-Based Medicine in Oxford are trying to solve the problems of both numbers and clinical applicability by catalysing the execution of large (>100 clinicians enrolling >1000 patients), simple (<2 minutes per patient and <15 patients per participating clinician), fast (<2 weeks, with automatic data entry via the Internet) studies of the accuracy and precision of specific elements of the history and physical examination. Their initial efforts led to >160 clinicians from 20 countries joining CARE.
This page is an invitation to other clinical colleagues around the world to join this enterprise.
CARE works like this:
- Anybody, at any stage of training or experience, can join the enterprise just by signing up for it. The only pre-requisites are an interest in the clinical examination, ACCESS TO THE INTERNET (for that's how we'll do our work), and well-developed sense of humour.
- Individuals in the collaboration nominate symptoms and signs they'd like to validate (or debunk!) and broadcast them to the membership.
- Members who share an interest in this same topic come together electronically as Investigators, and proceed to design and debug the protocol and offer it to the entire collaboration.
- The membership-at-large vote with their precious time, enrolling just a few patients each and reporting their results electronically.
- Analyses are shared, PowerPoint summaries posted, and papers published (with authorship by the Investigators, on behalf of CARE, and acknowledging every member who entered the requisite number of patients).
Our membership already is over 600, but our target is at least 1000 colleagues around the world. Our objectives are good science, better examinations, and lots of fun.
Sharon E. Straus,
Toronto Western Hospital
U. of Toronto
sestraus@rogers.com
Finlay McAlister,
U. of Alberta Hospital
Edmonton, Alberta
David L. Sackett,
Kilgore Trout Research & Conference Centre
Irish Lake
sackett@bmts.com
If so, please let us know. Prepare a brief paragraph describing the study rationale and the question that is of interest to you and email it to us at carestudy@rogers.com and we will forward it to the CARE members. Interested members will come together electronically and led BY YOU as the principal investigator, develop a protocol. Protocols are placed on the CARE website for all CARE members to review. If the study is of interest to CARE members, it will be completed by the group, again led by you.
Friends of the CARE Study web site include:
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Bandolier | Evidence-based health care | |
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LinuxMedNews | ||
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TGH-UHN CEBM | Toronto General Hospital - University Health Network Centre for Evidence-Based Medicine | |
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NHS R&D CEBM | Centre for Evidence-Based Medicine | |
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Clinical Examination | Clinical Examination Research Interest Group |
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