Hermans J, et al. JAMA. 2013 Aug 28;310(8):837-47.
This systematic review of studies comparing clinical tests for rotator cuff disease with a diagnostic reference standard of MRI or U/S found that positive tests of internal rotation lag ((+)LR 5.6, 95% CI 2.6 – 12), external rotation lag (LR 7.2, 95% CI 1.7 – 31), and the painful arc ((+)LR 3.7, 95% CI 1.9 - 7.0) have the highest positive likelihood ratios for rotator cuff disease. JC attendees agreed that the question is useful, but that the studies included in this systematic review lacked reproducibility and generalizability to an emergency department population, and that their large 95% CI’s preclude the utility of these results in changing our daily practice. By: Dr. Laura Francis
Epi lesson: Verification Bias When critically appraising a study evaluating a diagnostic test, it is important to examine th…