A novel approach to the determination of clinical decision thresholds.
A novel approach to the determination of clinical decision thresholds.
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DOI：
10.1136/ebmed-2014-110140
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发表时间：
2015-04-01
期刊：
影响因子：
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通讯作者：
Senn, Nicolas
中科院分区：
文献类型：
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作者：
Ebell, Mark H;Locatelli, Isabella;Senn, Nicolas
我们的目标是确定常见急性初级保健条件的测试和治疗阈值。我们向200名临床医生提供了一系列基于网络的临床小插曲，描述了可能患有流感、急性冠状动脉综合征（ACS）、肺炎、深静脉血栓形成（DVT）和尿路感染（UTI）的患者。我们随机改变了疾病的概率，并询问临床医生是否想要排除疾病，进行测试或排除疾病。通过随机改变概率，我们在广泛的疾病概率范围内获得了临床决策，我们用来创建阈值曲线。对于流感，检测（4.5%对32%，p
Our objective was to determine the test and treatment thresholds for common acute primary care conditions. We presented 200 clinicians with a series of web-based clinical vignettes, describing patients with possible influenza, acute coronary syndrome (ACS), pneumonia, deep vein thrombosis (DVT) and urinary tract infection (UTI). We randomly varied the probability of disease and asked whether the clinician wanted to rule out disease, order tests or rule in disease. By randomly varying the probability, we obtained clinical decisions across a broad range of disease probabilities that we used to create threshold curves. For influenza, the test (4.5% vs 32%, p