Abstract
OBJECTIVE: To test the reliability of bimanual pelvic examinations performed in emergency departments by emergency medicine physicians. DESIGN: Prospective observational study; 2 examiners each recorded various pelvic examination findings on 186 patients. SETTING: A private university hospital and a public county hospital staffed by attending emergency medicine physicians who share an emergency medicine residency program. SUBJECTS: Senior resident (3rd or 4th year) and attending emergency physicians. MAIN OUTCOME MEASURES: 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%. CONCLUSION: The findings of bimanual pelvic examinations performed by emergency physicians in an emergency department have poor interexaminer reliability.