Journal of General Internal Medicine

, Volume 10, Issue 8, pp 455–457

Accuracy and reliability of apical S3 gallop detection

  • Eric C. Westman
  • David B. Matchar
  • Gregory P. Samsa
  • Cynthia D. Mulrow
  • R. A. Waugh
  • John R. Feussner
Brief Reports

DOI: 10.1007/BF02599919

Cite this article as:
Westman, E.C., Matchar, D.B., Samsa, G.P. et al. J Gen Intern Med (1995) 10: 455. doi:10.1007/BF02599919

Abstract

This study assessed physician performance in detecting the apical S3 gallop using a cardiology patient simulator. Six physicians (two cardiology fellows, two medicine residents, and two attending physicians) performed two sets of 24 cardiac examinations that included the presence or absence of an apical S3 gallop. All the examiners were able to significantly alter the prior odds of an apical S3 gallop’s being present, but the cardiology fellows had higher sensitivities. Sensitivity was lower for detecting soft S3 gallops, and specificity was lower when a diastolic murmur was also present. Physician performance in detecting apical S3 gallops is variable, but can be excellent.

Key words

physical examinationheartlikelihood ratiosensitivityspecificityphysiciansapical S3 gallop

Copyright information

© Society of General Internal Medicine 1995

Authors and Affiliations

  • Eric C. Westman
    • 1
    • 2
    • 3
  • David B. Matchar
    • 1
    • 2
    • 3
    • 4
  • Gregory P. Samsa
    • 1
    • 2
    • 3
  • Cynthia D. Mulrow
    • 6
  • R. A. Waugh
    • 5
  • John R. Feussner
    • 1
    • 2
    • 3
  1. 1.the Center for Health Services Research in Primary CareDuke UniversityDurham
  2. 2.Durham Veterans Affairs Medical CenterDuke UniversityDurham
  3. 3.the Division of General MedicineDuke UniversityDurham
  4. 4.the Center for Health Policy Research and EducationDuke UniversityDurham
  5. 5.the Division of CardiologyDuke UniversityDurham
  6. 6.the Division of General MedicineAudie L. Murphy Memorial Veterans HospitalSan Antonio
  7. 7.Center for Health Services Research in Primary Care (152)Durham Veterans Affairs Medical CenterDurham