Reliability of bimanual pelvic examinations performed in emergency departments

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Abstract
To test the reliability of bimanual pelvic examinations performed in emergency departments by emergency medicine physicians. Prospective observational study; 2 examiners each recorded various pelvic examination findings on 186 patients. A private university hospital and a public county hospital staffed by attending emergency medicine physicians who share an emergency medicine residency program. Senior resident (3rd or 4th year) and attending emergency physicians. Percentage of agreement and percentage of positive agreement for cervical motion tenderness, uterine tenderness, adnexal tenderness, adnexal mass, and uterine size (within 2 cm). 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%. The findings of bimanual pelvic examinations performed by emergency physicians in an emergency department have poor interexaminer reliability.