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What we should know about diagnostic tests


Authors: H. Mann
Authors‘ workplace: Revmatologický ústav, Praha
Published in: Čes. Revmatol., 21, 2013, No. 2, p. 98-104.
Category: Comments

Medicína je věda o nejistotě a umění pravděpodobnosti.
Sir William Osler

Overview

Diagnostic tests play a very important role in rheumatology. Despite the fact that we use them on daily basis, we often do not appreciate the influence of basic statistical principles on their interpretation. Rheumatic diseases are rare, therefore in order to avoid falsely positive results we have to order diagnostic tests only in patients with strong suspicion of a given disease. Understanding of diagnostic test characteristics and the basics of bayesian approach alows us to combine diagnostic tests in an effective manner in order to minimize costs and risks associated with ruling-in or ruling-out a disease.

Key words:
Diagnostic test, uncertainity, sensitivity, specificity, predictive value


Sources

1. Gross R. Making clinical decisions. ACP, Philadelphia 1999.

2. Fagan TJ. Letter: Nomogram for Bayes theorem. N Engl J Med 1975; 293: 257.

3. Nishimura K, Sugiyama D, Kogata Y, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis. Ann Intern Med 2007; 146: 797-808.

Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
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