When we are trying to figure out our patient’s health problem as health care providers, we are usually starting with screening for serious pathologies, followed by patient history-taking and physical examination also called assessment.
By the use of multiple questions, we are trying to form different hypotheses about our patient’s condition. Each answer by our patient that fits into a certain clinical picture, makes a hypothesis more or less likely.
Physical Examination Tests, also known as “Special Tests”, can be used either at the end of our screening procedure (usually to rule out a serious pathology) or at the end of our patient history-taking to either confirm or reject different hypotheses.
There is nothing special about special tests: Like any question during our patient interview, they are either rendering a hypothesis more or less likely – that’s it!
At the same time, not all physical examination tests are created equal. Their power to increase or decrease the likelihood of a certain pathology depends on their accuracy.
Simultaneously, a pre-condition for accuracy is that a clinical test is reproducible by one or more examiners, which is what we call reliability.