What is evidence in diagnosis

Elias Peter pheski69 at GMAIL.COM
Sat Mar 31 20:11:11 UTC 2018


Thank you for the thought-provoking perspective.

I have difficulty with this line:

>  But when we look at how diagnosis is performed in practice, such as in published clinicopathologic conferences ( CPCs ) and clinical problem solving exercises, we find evidence is not assessed in terms of a probability ( 2,3 ). 


I do not think that published CPCs or clinical problem solving exercises are a reliable way to determine how diagnoses are made in practice.

Peter Elias, MD


On 2018.03.21, at 1:00 PM, Jain, Bimal P.,M.D. <BJAIN at PARTNERS.ORG> wrote:

In this attached paper, I discuss how evidence is assessed during diagnosis in practice .I argue that evidence is not assessed by a probability as prescribed because a probability which is a frequency in a population fails to represent evidence for a disease in a given, individual patient in whom diagnosis is performed. Instead evidence is assessed in terms of likelihood ratio and a disease diagnosed from it in practice as we see in all published CPCs and clinical problem solving exercises.
Please review and comment on this paper.
Thanks.
 
Bimal  
 
Bimal P Jain MD
Northshore Medical Center
Lynn MA 01904. 

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