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  Vol. 265 No. 17, May 1, 1991 TABLE OF CONTENTS
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  Toward Optimal Laboratory Use
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Diminishing Returns on the Road to Diagnostic Certainty

Horton A. Johnson, MD

JAMA. 1991;265(17):2229-2231.


Abstract

In the quest for diagnostic certainty, one can be led into a false sense of accomplishment by the results of sensitive, specific, and well-executed diagnostic tests that provide little or no diagnostic information. This is a consequence of the fact that as one approaches diagnostic certainty the useful information returned by diagnostic tests and observations approaches zero. This can be demonstrated by calculating the quantity of useful information provided by a test in a given clinical environment as one approaches certainty of diagnosis.

(JAMA. 1991;265:2229-2231)



Author Affiliations

From the Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY.


Footnotes

Reprint requests to 30 W 61st St, Suite 21B, New York, NY 10023 (Dr Johnson).



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