Academic calculations versus clinical judgments : Practicing physicians'use of quantitative measures of test accuracy.
To determine how often practicing physicians use the customarily recommended quantitative methods that include sensitivity, specificity, and likelihood ratio indexes ; receiver operator characteristic (ROC) curves ; and Bayesian diagnostic calculations.
PARTICIPANTS AND METHODS
A random sample of 300 practicing physicians (stratified by specialty to include family physicians, general internists, general surgeons, pediatricians, obstetrician/gynecologists, and internal medicine sub-specialists) were briefly interviewed in a telephone survey.
They were asked about the frequency with which they used the formal methods, the reasons for non-use, and if they employed alternative strategies when appraising tests'diagnostic accuracy.
Of the 300 surveyed physicians, 8 (3%) used the recommended formal Bayesian calculations, 3 used ROC curves, and 2 used likelihood ratios.
The main reasons cited for non-use included impracticality of the Bayesian method (74%), and nonfamiliarity with ROC curves and likelihood ratios (97%). Of the 174 physicians who said they used sensitivity and specificity indexes, 165 (95%) did not do so in the recommended formal manner.
Instead, the physicians directly estimated tests'diagnostic accuracy by determining how often the test results were correct in groups of patients later found to have, or to be free of, the selected disease. (...)
Mots-clés Pascal : Méthode mesure, Analyse quantitative, Etude théorique, Test clinique, Médecin, Evaluation, Diagnostic, Méthode ROC, Détection Bayes, Maladie, Etude comparative, Homme, Pratique professionnelle
Mots-clés Pascal anglais : Measurement method, Quantitative analysis, Theoretical study, Clinical test, Physician, Evaluation, Diagnosis, Receiver operating characteristic curves, Bayes detection, Disease, Comparative study, Human, Professional practice
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0244903
Code Inist : 002B30A01C. Création : 11/09/1998.