Primer on certain elements of medical decision making

N Engl J Med. 1975 Jul 31;293(5):211-5. doi: 10.1056/NEJM197507312930501.


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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Bayes Theorem
  • Decision Making*
  • Diagnosis*
  • False Negative Reactions
  • False Positive Reactions
  • Health Expenditures
  • Humans
  • Information Theory
  • Liver Diseases / diagnosis
  • Morbidity
  • Mortality
  • Probability
  • Radionuclide Imaging
  • Statistics as Topic
  • United States