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A Mathematical Approach to Interpretation and Selection of Diagnostic Tests

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  • Peter Doubilet

Abstract

When the presence of a specific disease is being considered, a diagnostic test can often help the physician to choose between subjecting the patient to an extensive workup (or treatment) and proceeding no further. Decisions concerning the use of a test require that three judgments be made: (1) Should the test be done? (2) Which test (if any) should be used if two or more are available? (3) If a test that can take on more than two values is performed, what is the correct cutoff point (or positivity cri terion) that determines whether or not to proceed? This paper presents a mathemati cal technique to answer these questions, taking into account data concerning the patient (summarized as the prior, or pre-test, probability of disease), the test, and the workup (or treatment). The technique is presented in a graphical form that can be applied to any clinical situation in which the needed data are available. (Med Decis Making 3:177-195, 1983)

Suggested Citation

  • Peter Doubilet, 1983. "A Mathematical Approach to Interpretation and Selection of Diagnostic Tests," Medical Decision Making, , vol. 3(2), pages 177-195, June.
    • Handle: RePEc:sae:medema:v:3:y:1983:i:2:p:177-195
    DOI: 10.1177/0272989X8300300206
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    References listed on IDEAS

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    1. John R. Clarke & John M. Eisenberg, 1981. "A Theoretical Assessment of the Value of the PTT as a Preoperative Screening Test in Adults," Medical Decision Making, , vol. 1(1), pages 40-43, February.
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    Cited by:

    1. Eeckhoudt, Louis & Bauwens, Luc & Lebrun, Thérèse, 1987. "Théorie de l’information et diagnostic médical : une analyse coût-efficacité," L'Actualité Economique, Société Canadienne de Science Economique, vol. 63(2), pages 243-255, juin et s.
    2. Paul Glasziou & Jörgen Hilden, 1986. "Threshold Analysis of Decision Tables," Medical Decision Making, , vol. 6(3), pages 161-168, August.
    3. Barry R. Davis & Lawrence M. Friedman & Edgar Lichstein, 1988. "The Prognostic Value of the Duration of the Ambulatory Electrocardiogram after Myocardial Infarction," Medical Decision Making, , vol. 8(1), pages 9-18, February.
    4. Paul Glasziou & Jörgen Hilden, 1986. "Decision Tables and logic in Decision Analysis," Medical Decision Making, , vol. 6(3), pages 154-160, August.
    5. Peter E. Krumins & Stephan D. Fihn & Daniel L. Kent, 1988. "Symptom Severity and Patients' Values in the Decision to Perform a Transurethral Resection of the Prostate," Medical Decision Making, , vol. 8(1), pages 1-8, February.
    6. Tom J. Wachtel & David B. Reuben & John P. Fulton & Steven A. Wartman, 1985. "The Use of the "Range of Uncertainty"," Medical Decision Making, , vol. 5(3), pages 325-334, August.

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