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This case study began
as an examination of how to express certainty and uncertainty
of a diagnosis. Think back to your original estimate of the probability
that the case study patient's symptoms were due to myocardial
ischemia.
Now, considering the
heuristics of subjective estimates, the usefulness and limitations
of disease prevalence estimates, and the application and interpretation
of clinical prediction rule scores, what do you feel is gained
by framing this diagnostic problem in terms of probability?
The author suggests
these benefits:
- We gain respect
for the imperfections of tests, since neither examined in this
case study leads to diagnostic certainty for this patient.
- We make a rational
decision to get a somewhat more expensive test because we have
proved to ourselves that it would be more useful.
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