Gomez de la Camara A
Unidad de Epidemilogía Clínica, Unidad de Investigación Hospital Doce de Octubre, Insalud Area 11, Madrid, Spain.
Neurologia. 2003 Dec;18 Suppl 2:11-8.
The aim of the diagnostic process is to establish the prevalence or probability of a disease given a clinical picture. A diagnostic test could be considered as every piece of information obtained from a patient. Diagnostic test can be done throughout technical devices, medical examinations or questionnaire. The diagnostic test offers information that allows us to classify patients according a different probability to be sick. The operative validity of a test can be done in terms of diagnostic accuracy. It means the ability to truly classify a patient in the right clinical situation. Diagnostic accuracy is the quality of the information provided by a test (sensitivity, specificity). Diagnostic usefulness is the practical value of the provided information. The predictive value of a diagnostic test depends on its accuracy and the prevalence of the disease in the setting where the diagnostic process is to be made. Decision making with the information provided by the test implies to consider the consequences of the false result.
诊断过程的目的是根据临床表现确定疾病的患病率或概率。诊断测试可以被视为从患者那里获得的每一条信息。诊断测试可以通过技术设备、医学检查或问卷调查来进行。诊断测试提供的信息使我们能够根据不同的患病概率对患者进行分类。测试的操作有效性可以根据诊断准确性来判断。这意味着能够在正确的临床情况下准确地对患者进行分类。诊断准确性是测试提供的信息的质量(敏感性、特异性)。诊断有用性是所提供信息的实用价值。诊断测试的预测价值取决于其准确性以及在进行诊断过程的环境中疾病的患病率。根据测试提供的信息进行决策意味着要考虑错误结果的后果。