Optimizing Diagnostic Test Sequences: The Probability Modifying Plot

J. L. Severens; P. F. de Vries Robbé; A. L. M. Verbeek

doi:10.1055/s-0038-1634143

Methods of Information in Medicine, Table of Contents

Methods Inf Med 1999; 38(01): 50-55
DOI: 10.1055/s-0038-1634143

Original article

Schattauer GmbH

Optimizing Diagnostic Test Sequences: The Probability Modifying Plot

J. L. Severens

¹Department of Medical Informatics, Epidemiology and Statistics, University of Nijmegen, The Netherlands

,

P. F. de Vries Robbé

¹Department of Medical Informatics, Epidemiology and Statistics, University of Nijmegen, The Netherlands

,

A. L. M. Verbeek

¹Department of Medical Informatics, Epidemiology and Statistics, University of Nijmegen, The Netherlands

› Author Affiliations

Abstract

Abstract:

The problem of deciding the optimal sequence of diagnostic tests can be structured in decision trees, but unmanageable bushy decision trees result when the sequence of two or more tests is investigated. Most modelling techniques include tests on the basis of gain in certainty. The aim of this study was to explore a model for optimizing the sequence of diagnostic tests based on efficiency criteria. The probability modifying plot shows, when in a specific test sequence further testing is redundant and which costs are involved. In this way different sequences can be compared. The model is illustrated with data on urinary tract infection. The sequence of diagnostic tests was optimized on the basis of efficiency, which was either defined as the test sequence with the least number of tests or the least total cost for testing. Further research on the model is needed to handle current limitations.

Keywords:

Diagnostic Tests - Test Sequence - Decision Analysis

Full Text

References

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