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Orthopaedic special tests and diagnostic accuracy studies: house wine served in very cheap containers
  1. Eric J Hegedus1,
  2. Alexis A Wright1,
  3. Chad Cook2
  1. 1 Department of Physical Therapy, High Point University, High Point, North Carolina, USA
  2. 2 Doctor of Physical Therapy Division, Duke University, Durham, North Carolina, USA
  1. Correspondence to Dr Eric J Hegedus, Department of Physical Therapy, High Point University, One University Parkway, High Point, NC 27268, USA; ehegedus{at}highpoint.edu

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House wine is the abstruse alcoholic drink sold by restaurants to thirsty, unquestioning individuals who are looking for the path of least resistance. House wine is easily accessible, simplifies an oft-complex process and ‘feels’ like its highbrow cousins. House wine is alluring to sellers of wine because it appeals to the masses and is profitable. House wine meets a need; but its packaging (usually a box) is generally looked down upon by discerning consumers since it signals lack of quality.

Unfortunately, orthopedic special tests are the house wine of the research community and diagnostic accuracy studies are the cheap containers in which they are served.

Before you object too strenuously, we submit the following case (or box, sticking with the theme). Like cheap wine, orthopaedic special tests are ubiquitous. Our quick search of PubMed using ‘diagnostic accuracy and orthopaedic tests’ revealed 539 articles (most of them relevant). Beyond primary literature, a Google search for orthopaedic special tests elicited 967, 000 results including textbooks and websites. Textbooks frequently introduce a litany of tests; often including similar tests with variable names and no discriminating properties. YouTube is laden with demonstrations of selected tests. This popularity begs the question, ‘Why?’

For the sellers of the ‘house wine’, for example, researchers and journals, orthopaedic tests …

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