To test or not to test--to treat or not to treat: the decision-threshold approach to patient management

J Gen Intern Med. 1986 May-Jun;1(3):177-82. doi: 10.1007/BF02602334.


The inability to consider explicitly factors that should enter into clinical judgment compromises physician efforts to make cost-effective decisions regarding diagnostic testing and treatment. The authors describe the decision-threshold approach, a decision-analysis strategy that helps physicians identify an optimal test-treatment decision based upon the prior probability of disease, the characteristics of the test (sensitivity, specificity, risk), and the benefits/costs of treatment. They also present a microcomputer graphics program that makes the decision-threshold approach readily available to physicians.

MeSH terms

  • Computer Graphics
  • Cost-Benefit Analysis
  • Decision Theory
  • Diagnosis*
  • Humans
  • Microcomputers
  • Probability
  • Therapeutics*