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Lookup NU author(s): Dr Robbie Foy
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Clinical guidelines often make recommendations on the use of diagnostic tests. Compared with sensitivity and specificity, the use of pre- and post-test probabilities allows a more explicit and rational selection and interpretation of diagnostic tests. Ideally, clinical guidelines relating to diagnosis should routinely incorporate this information to enhance individualised decision making. We report our experience of incorporating pre- and post-test probabilities into a guideline on the investigation of women with postmenopausal bleeding developed by the Scottish Intercollegiate Guidelines Network. Issues relating to their application are highlighted, including the limitations of available evidence on diagnostic tests and prevalence of disease, acceptability to guideline users, and the uncertain impact on actual clinical decision making. Despite these potential difficulties, the incorporation of data on pre- and post-test probabilities into the development and presentation of guideline recommendations may offer an important opportunity to make clinical decision making more transparent for both clinicians and patients.
Author(s): Foy R, Warner P
Publication type: Review
Publication status: Published
Journal: Quality and Safety in Health Care
Year: 2003
Volume: 12
Issue: 3
Pages: 205-209
Print publication date: 01/06/2003
ISSN (print): 0963-8172
ISSN (electronic):
URL: http://dx.doi.org/10.1136/qhc.12.3.205
DOI: 10.1136/qhc.12.3.205
PubMed id: 12792011