Test-indication curves
Test-indication curves
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DOI：
10.1177/0272989x9701700112
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发表时间：
1997-01-01
影响因子：
3.6
通讯作者：
Bernstein, J
中科院分区：
文献类型：
--
作者：
Bernstein, J
测试指示曲线（TIC）是用于确定测试是否适用于给定患者的工具。他们以图表形式应用Pauker和Kassirer的阈值方法。这些曲线由两部分组成：原始曲线，绘制后测概率与前测概率（特异性和灵敏度的给定值）;最终曲线，临床医生将三条直线添加到原始曲线中，以生成给定治疗阈值的Tie。在最后的曲线中，预检验概率的完整范围被分成三个区域，对应于Pauker和Kassirer描述的三个组：假定存在疾病的患者，因此最好根据经验进行治疗;另一个极端，既不需要检测也不需要治疗的患者;最后是那些处于中间的人，因为治疗的决定将基于测试结果。因此，临床医生可以咨询TIC，并确定是否应该对给定的患者进行测试。它也可以针对不同的患者容易地修改，具有不同的阈值集合。TIC在给定治疗阈值的背景下提供了对测试诊断能力的完整的视觉解释。它们促进了对Pauker和Kassirer方法的直观理解，并为临床医生提供了一种简便的方法来证明测试在给定环境中是适用的。通过推广使用指定的测试，TIC可以帮助患者免除不必要测试的成本、负担和风险，并帮助医生免除解释不确定测试结果的成本、负担和风险。
Test-indication curves (TICs) are tools for determining whether a test is indicated for a given patient. They apply the threshold approach of Pauker and Kassirer in graphic form. These curves are composed of two parts: the raw curve, which plots posttest probability versus pretest probability (given values for specificity and sensitivity); and the final curve, in which three straight lines are added to the raw curve by the clinician to generate a Tie for a given treatment threshold. In the final curve, the complete range of pretest probability is segregated into three zones, corresponding to the three groups described by Pauker and Kassirer: those patients in whom disease is assumed to be present and who are thus best treated empirically; at the other extreme, those who require neither testing nor treatment; and, finally, those in the middle, for whom the test is indicated, since the decision to treat would be based on the test result. Thus the clinician could consult the TIC and determine with certainty whether the test should be employed for a given patient. It also could be modified with ease for a different patient, with a different set of threshold values. TICs provide a complete, visual interpretation of a test's diagnostic power, in the context of a given treatment threshold. They foster an intuitive comprehension of Pauker and Kassirer's method, and offer the clinician a facile means to prove that a test is indicated in a given setting. By promoting the use of exactly those tests that are indicated, TICs can help spare the patient the cost, burden, and risk of unnecessary testing, and help spare the physician the cost, burden, and risk of interpreting inconclusive test results.