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Have guidelines lost their way?
  1. Philip D Welsby
  1. Retired, Edinburgh, UK
  1. Correspondence to Philip D Welsby, Retired, Edinburgh, UK; philipwelsby{at}

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The paper ‘The 5.3.5 rule for examining the muscles of the upper limb’ by Peter Gates1 contains many inter-related facts in effect constituting an algorithmic approach to the patterns of upper limb weakness. This approach begs several important questions, all based on the wide spectrum of neurological abilities possessed by individuals and on the numerous types of thinking (concrete vs abstract, convergent vs divergent, creative vs analytical and sequential vs holistic) that we all possess or lack to a greater or lesser degree.

Can most physicians absorb and remember complex long sequences of instructions when memory for random number sequences for an average adult is only about seven?

What is our ability to absorb information from complex tables or diagrams? The answer is that the range of abilities is wide but on average poor. Few could match a medical student who as part of an appreciation of the tests used to monitor possible …

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  • Contributors I am sole contributer.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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