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Michael Huiras, MD
Hennepin County Medical Center Minneapolis

JAMA. 1984;251(17):2207.

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

To the Editor.—

I must say that I was initially startled by the findings of Zarling et al¹ regarding the inability of non-internal medicine specialists to diagnose classic myocardial infarction with accompanying ECG and/or enzyme level changes.

However, closer inspection of the data reveals that it is the statisticians rather than the physicians who are accountable for the described 0% diagnostic accuracy when dealing with these so-called class I myocardial infarctions. What the authors have done (as shown in Table 3 of their article) is to take the number of correct diagnoses by the noninternists (surgeons) in this category— zero—and divide it by the number of cases with which they were presented, which is also zero. The resulting fraction, 0/0, is not mathematically interpretable. In no way can it be multiplied by 100 and expressed as 0% as the authors have done in treating the data. The best that . . . [Full Text PDF of this Article]

Footnotes
Edited by John D. Archer, MD, Senior Editor.

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