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Frank Vinicor, MD, MPH

JAMA. 1999;281:1222-1224.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Perhaps no component of medical care is more important to subsequent care than establishing a diagnosis. From this step decisions emerge about treatment, prognosis, and use of health resources. Clinicians depend on many types of information to establish a diagnosis including, for example: history of angina and coronary artery disease; physical examination finding of hard testicular lesion and cancer; radiographic results showing apple-core colon lesion and cancer; electrocardiogram results showing Q waves and myocardial infarction; and laboratory test results finding elevated serum creatinine and uremia.

Particularly for laboratory tests, separation of normal from abnormal is inevitably arbitrary.¹ Often, abnormality is based on a statistical process, such as greater than 2 SDs above a mean value for a population. In other cases, values are related to the likelihood of a particular laboratory value being associated with a subsequent adverse event developing in the future, for instance, plasma . . . [Full Text of this Article]

Author Affiliation: Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Ga.

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