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Intern Med J. 2008 Feb;38(2):120-9. Epub 2007 Jul 23.

Cautionary tales in the clinical interpretation of studies of diagnostic tests.

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Department of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia.


The use of investigational tests in making a diagnosis is a core activity of physicians and one that requires an understanding of the accuracy and usefulness of specific tests in discriminating between several diagnostic possibilities. Studies of diagnostic tests are frequently methodologically flawed and their results are often not well understood or applied in clinical practice. This article defines the performance characteristics of diagnostic tests, describes several commonly encountered deficiencies in study design which may invalidate reports of new diagnostic tests, and explains a Bayesian approach to interpreting test results in terms of disease probability.

[Indexed for MEDLINE]

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