Evidence-Based Practice II: Diagnostic Evidence, Clinical Prediction Rules, and Accuracy Statistics

Evidence-Based Practice II: Diagnostic Evidence, Clinical Prediction Rules, and Accuracy Statistics

Current Focus: Diagnostic Evidence

This class (Class 3, Fall 2025) will cover:

• The diagnostic process and the role of diagnostic tests.

• Key numerical and statistical concepts in diagnostics.

• Appraisal of diagnostic evidence.

Specifically, today's topics include:

• Clinical Prediction Rules (CPRs) & Clusters: A special type of diagnostic test.

• The Math/Statistics Used in Diagnostics.

• Reading Articles and Tables related to diagnostic evidence.

Review of the Diagnostic Process

• Goal: To adjust pre-test probability to achieve a post-test probability, with the ultimate goal of reaching actionable certainty.

• Process: Diagnostic testing is used to revise the probability of having a condition.

  • Pre-test Probability: The initial likelihood of a condition existing before any diagnostic test.

  • Diagnostic Testing: The application of specific tests.

  • Post-test Probability: The revised likelihood of a condition after a diagnostic test.

• Thresholds:

  • Test Threshold: The probability below which no further testing is needed to rule out a condition.

  • Treatment Threshold: The probability above which treatment should commence, meaning further testing is not needed to rule in a condition.

  • The aim is to move from the middle