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the claim
Frank's sign is a clinically significant indicator of cardiovascular disease
the verdict
CONTESTED
the evidence cuts both ways
confidence 39/100

While Frank's sign (diagonal earlobe crease) demonstrates a statistically significant association with cardiovascular disease and related conditions, systematic evaluations question its reliability and diagnostic accuracy as a standalone clinical indicator.

The evidence we hold leans evenly split

How this was weighed

official record 3x · fact-check 2x · hedged 1x · crowd & reference 1x

  • Relationship between diagonal earlobe crease (Frank's sign) · peer-reviewed · supports · weight 1 · 2023
  • Diagonal earlobe crease (Frank's sign) predicts obstructive · peer-reviewed · supports · weight 1 · 2023
  • Exploring the Potential of Earlobe Crease as an Indicator of · peer-reviewed · supports · weight 1 · 2024
  • Diagonal Earlobe Crease (Frank’s Sign) for Diagnosis of Coro · peer-reviewed · refutes · weight 1.3 · 2021
  • Diagonal earlobe crease (Frank's sign) predicts obstructive · peer-reviewed · refutes · weight 1 · 2023
Evidence for · 3
Relationship between diagonal earlobe crease (Frank's sign) and international index of erectile dysfunction score (IIEF-5)
2023 · cited by 0
This study found that diagonal earlobe crease is associated with atherogenic erectile dysfunction, supporting its role as a clinical indicator.
Evidence against · 2
Diagonal Earlobe Crease (Frank’s Sign) for Diagnosis of Coronary Artery Disease: A Systematic Review of Diagnostic Test Accuracy Studies
2021 · cited by 27
This systematic review concluded that the diagnostic accuracy of the diagonal earlobe crease for detecting coronary syndromes is insufficient to affect clinical management.
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More for · 2
Diagonal earlobe crease (Frank's sign) predicts obstructive coronary artery disease with modest accuracy
2023 · cited by 0
This study notes that bilateral Frank's sign is independently associated with coronary artery disease in a multivariate logistic regression model.
Exploring the Potential of Earlobe Crease as an Indicator of Coronary Artery Disease Risk: A Preliminary Case Study in Nepal
2024 · cited by 0
This case study and review suggests that Frank's sign is a useful, simple physical finding for the early discovery of cardiovascular risk.
More against · 1
Diagonal earlobe crease (Frank's sign) predicts obstructive coronary artery disease with modest accuracy
2023 · cited by 0
This study found that despite an independent statistical association, the diagnostic accuracy of Frank's sign is modest, rendering it an unreliable clinical marker.
The paper trail · every fact has a biography
first checked02 Aug 2026
judged → CONTESTED · 3902 Aug 2026
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