Primer on certain elements of medical decision making

BJ McNeil, E Keeler, SJ Adelstein - New England Journal of …, 1975 - Mass Medical Soc
New England Journal of Medicine, 1975Mass Medical Soc
The value of a diagnostic test lies in its ability to detect patients with disease (its sensitivity)
and to exclude patients without disease (its specificity). For tests with binary outcomes, these
measures are fixed. For tests with a continuous scale of values, various cutoff points can be
selected to adjust the sensitivity and specificity of the test to conform with the physician's
goals. Principles of statistical decision theory and information theory suggest technics for
objectively determining these cutoff points, depending upon whether the physician is …
Abstract
The value of a diagnostic test lies in its ability to detect patients with disease (its sensitivity) and to exclude patients without disease (its specificity). For tests with binary outcomes, these measures are fixed. For tests with a continuous scale of values, various cutoff points can be selected to adjust the sensitivity and specificity of the test to conform with the physician's goals. Principles of statistical decision theory and information theory suggest technics for objectively determining these cutoff points, depending upon whether the physician is concerned with health costs, with financial costs, or with the information content of the test. (N Engl J Med 293:211–215, 1975)
The New England Journal Of Medicine