While reliability is not therefore a good measure for testing the quality of a Part 2 examination, even when the examination is equivalent to the Part 1, the SEM is a good measure, maintaining its value even when the range is restricted.
This led to reluctance on the part of participants to approach patients to ask permission to examine them, even when the examination was not an intimate examination.
We suggest that when a patient presents with a TCH an expanded assessment with MRI of the brain should be ordered to rule out a cerebral infarct, even when neurological examination, brain CT, and CSF examination are normal as in our case.
This study lends further support to the literature that suggests doctors have limited ability to estimate their examination performance, even when the examinations are in a familiar format (SBA and OSCE).
This was our rationale for collecting induced sputum even when history, examination, and chest radiograph were unremarkable.
The present case demonstrates the importance of pathologic confirmation, even when clinical examination suggests that a lesion is likely benign with clinically typical presentation.
Perhaps we should also be more explicit in encouraging sensitivity to parental concern, stressing that it does make the presence of serious illness more likely even when clinical examination is reassuring.
Even when histological examination of the resected liver is used as the 'gold standard' the verification of very small lesions is questionable since most specimens are sectioned at 1 cm intervals.
Even when medical examinations are granted, they are often "sub-standard, losing precious evidence and skewing subsequent decisions not to open investigations into torture allegations".
However, the identification of nodal disease from vascular structures has been improved with multislice CT, as vascular structures are now greatly enhanced and easily distinguished from lymph nodes, even when long examinations are presented with limited amounts of contrast.
