IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v7y1987i2p107-114.html
   My bibliography  Save this article

Intermediate, Indeterminate, and Uninterpretable Diagnostic Test Results

Author

Listed:
  • David L. Simel
  • John R. Feussner
  • Elizabeth R. Delong
  • David B. Matchar

Abstract

Diagnostic tests do not always yield positive or negative results; sometimes the results are intermediate, indeterminate, or uninterpretable. No consensus exists for the incorporation of such results into data assessment. Conventional Bayesian analysis leads investigators to either exclude patients with non-positive, non-negative results from their studies or categorize such results into inappropriate cells of the standard four-cell decision matrix. The authors propose a standardized method for reporting results in studies dealing with diagnostic test use and discuss how researchers should expand the four-cell matrix to six cells when non- positive, non-negative results occur. They suggest that the six-cell matrix with new operational definitions of sensitivity, specificity, likelihood ratios, and test yield should be adopted rou tinely. In addition, they define the different types of non-positive, non-negative results and demonstrate how clinicians can use tree-structured decision analysis from the six-cell matrix. While their method does not solve all problems posed by non-positive, non-negative results, it does suggest a standard method for reporting these results and utilizing all the data in decision making. Key words: diagnostic tests, Bayes theorem, decision analysis. (Med Decis Making 7:107-114, 1987)

Suggested Citation

  • David L. Simel & John R. Feussner & Elizabeth R. Delong & David B. Matchar, 1987. "Intermediate, Indeterminate, and Uninterpretable Diagnostic Test Results," Medical Decision Making, , vol. 7(2), pages 107-114, June.
  • Handle: RePEc:sae:medema:v:7:y:1987:i:2:p:107-114
    DOI: 10.1177/0272989X8700700208
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X8700700208
    Download Restriction: no

    File URL: https://libkey.io/10.1177/0272989X8700700208?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Joseph Lau & Andrew S. Levey & Jerome P. Kassirer & Stephen G. Pauker, 1982. "Idiopathic Nephrotic Syndrome in a 53-Year-Old Woman," Medical Decision Making, , vol. 2(4), pages 497-519, December.
    2. Thierry Poynard & Jean-Claude Chaput & Jean-Pierre Etienne, 1982. "Relations Between Effectiveness of a Diagnostic Test, Prevalence of the Disease, and Percentages of Uninterpretable Results," Medical Decision Making, , vol. 2(3), pages 285-297, August.
    3. R. Heather Palmer & Rose Strain & Janet K. Rothrock & Lee-Nah Hsu, 1983. "Evaluation of Operational Failures in Clinical Decision Making," Medical Decision Making, , vol. 3(3), pages 299-310, August.
    4. Mark S. Thompson & Barbara J. McNeil & R.D. Ganatra & P. Reed Larsen & S. James Adelstein, 1981. "Cost-Effectiveness of Screening for Hypo- and Hyperthyroidism in India," Medical Decision Making, , vol. 1(1), pages 44-58, February.
    5. Alan B. Cohen & Henry Klapholz & Mark S. Thompson, 1982. "Electronic Fetal Monitoring and Clinical Practice," Medical Decision Making, , vol. 2(1), pages 79-95, February.
    6. Robert A. Greenes & Kevin C. Cain & Colin B. Begg, 1984. "Patient-Oriented Performance Measures of Diagnostic Tests," Medical Decision Making, , vol. 4(1), pages 7-15, February.
    7. Deborah A. Zarin & Stephen G. Pauker, 1983. "Bilateral Pulmonary Infiltrates in an 11-Year-Old with Acute Lymphocytic Leukemia," Medical Decision Making, , vol. 3(2), pages 247-269, June.
    8. Robert A. Greenes & Colin B. Begg & Kevin C. Cain & John A. Swets & Carl E. Feehrer & Barbara J. McNeil, 1984. "Patient-Oriented Performance Measures of Diagnostic Tests," Medical Decision Making, , vol. 4(1), pages 17-31, February.
    9. Kevin C. Cain & Robert A. Greenes & Colin B. Begg, 1984. "Patient-Oriented Performance Measures," Medical Decision Making, , vol. 4(1), pages 33-46, February.
    10. David H. Hickam & Harold C. Sox JR & Keith I. Marton & Kelley M. Skeff & David Chin, 1982. "A Study of the Implicit Criteria Used in Diagnosing Chest Pain," Medical Decision Making, , vol. 2(4), pages 403-414, December.
    11. Anila Wijesinha & Colin B. Begg & H. Harris Funkenstein & Barbara J. McNeil, 1983. "Methodology for the Differential Diagnosis of a Complex Data Set," Medical Decision Making, , vol. 3(2), pages 133-154, June.
    12. J. Robert Beck & Dennis A. Plante & Stephen G. Pauker, 1981. "A 65-Year-Old Chinese Woman with Lymphadenopathy and Progressive Pulmonary Infiltrates," Medical Decision Making, , vol. 1(4), pages 391-414, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. Karel G.M. Moons & Theo Stijnen & Bowine C. Michel & Harry R. Büller & Gerrit-Anne Van Es & Diederick E. Grobbee & J. Dik F. Habbema, 1997. "Application of Treatment Thresholds to Diagnostic-test Evaluation," Medical Decision Making, , vol. 17(4), pages 447-454, October.
    3. Arthur Hartz & Robert Centor, 1986. "Measures of the Value of a Diagnostic Test Derived from Stochastic Thresholds," Medical Decision Making, , vol. 6(3), pages 149-153, August.
    4. Marvin L. Hage, 1987. "Management Decisions after Nonstress Testing," Medical Decision Making, , vol. 7(2), pages 97-103, June.
    5. Seong Woo Lee & Dowell Myers & Heon Soo Park, 2000. "An Econometric Model of Homeownership: Single-Family and Multifamily Housing Option," Environment and Planning A, , vol. 32(11), pages 1959-1976, November.
    6. Anna N. Angelos Tosteson & Colin B. Begg, 1988. "A General Regression Methodology for ROC Curve Estimation," Medical Decision Making, , vol. 8(3), pages 204-215, August.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:7:y:1987:i:2:p:107-114. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.