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Evaluation & the Health Professions
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The Impact of Clinical Appearance on Pediatric Residents' Assessment of the Febrile Infant

David A. Bergman

Arne L. Beck

Saint Francis Hospital and Medical Center

In order to examine physicians' use of clinical appearance versus historical and laboratory information in medical decision making, 29 pediatric residents were shown videotapes of febrile infants and accompanying clinical histories of varying severity. The results showed that contradictory visual and historical information led to higher, but much more variable, diagnostic likelihood estimates. Severity of appearance was directly related to further diagnostic and therapeutic action but was inversely related to confidence in diagnostic likelihood estimates. Clinical appearance plays an important role in medical decision making but when coupled with contradictory historical information may pose difficulties for physicians attempting to assess diagnostic likelihood.

Evaluation & the Health Professions, Vol. 9, No. 4, 449-458 (1986)
DOI: 10.1177/016327878600900404
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