title: Reliability of bimanual pelvic examinations performed in emergency departments.
abstract: OBJECTIVE
  To test the reliability of bimanual pelvic examinations performed in emergency departments by emergency medicine physicians.
  
  
  METHODS
  Prospective observational study; 2 examiners each recorded various pelvic examination findings on 186 patients.
  
  
  METHODS
  A private university hospital and a public county hospital staffed by attending emergency medicine physicians who share an emergency medicine residency program.
  
  
  METHODS
  Senior resident (3rd or 4th year) and attending emergency physicians.
  
  
  METHODS
  Percentage of agreement and percentage of positive agreement for cervical motion tenderness, uterine tenderness, adnexal tenderness, adnexal mass, and uterine size (within 2 cm).
  
  
  RESULTS
  The agreement ranged between 71% and 84%, but the percentage of positive agreement was much lower, ranging from 17% to 33%. Agreement for uterine size, within 2 cm, was 60%.
  
  
  CONCLUSIONS
  The findings of bimanual pelvic examinations performed by emergency physicians in an emergency department have poor interexaminer reliability.
authors.affiliation: University of California, Los Angeles (UCLA) Emergency Medicine Center, 924 Westwood Blvd, Ste 300, Los Angeles, CA 90024, USA. rclose@pol.net
authors.forename: R J
authors.initials: RJ
authors.lastname: Close
authors.forename: C J
authors.initials: CJ
authors.lastname: Sachs
authors.forename: P L
authors.initials: PL
authors.lastname: Dyne
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D002140:California; D002983:Clinical Competence; D004636:Emergency Service, Hospital; D005260:Female; D006766:Hospitals, County; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D017699:Pelvic Pain / Q000175:diagnosis* / Q000453:epidemiology; D010808:Physical Examination / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012494:Sampling Studies; D012680:Sensitivity and Specificity