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[评估检查结果及做出诊断决策的一般观点]

[General viewpoints in evaluating findings and making diagnostic decisions].

作者信息

Döring D

机构信息

Inneren Abteilung des Kreiskrankenhauses, Leisnig.

出版信息

Z Gesamte Inn Med. 1988 Jul 15;43(14):386-90.

PMID:3064448
Abstract

The process of diagnosis consists of establishment of findings, interpretation of findings and diagnostic decision. The general situation concerning decision is characterized by the fact that incorrect decisions may appear by falsely positive and falsely negative findings. On this assumption a diagnosis can only be confirmed with certain probability or excluded. Unequivocal decisions may be regarded as borderline cases of this situation concerning the decision. Their prerequisites are explained with the help of four-field table and diagrams belonging to this. If these conditions are not given, so that only a probable diagnosis can be made, then the indexes allow of an estimation of the degree of certainty of the evidence. By means of statistical models helps for decision can be obtained. The example of the Bayes-theorem is illustrated with the help of diagrams. In recent years another approach gathers momentum. The methods in question are so-called unclear approaches of the analysis of processes. They essentially support themselves on assessments by experts and on a programmed approach.

摘要

诊断过程包括确立检查结果、解读检查结果以及做出诊断决定。关于诊断决定的总体情况的特点是,错误的检查结果可能导致出现假阳性和假阴性诊断,从而做出错误的决定。基于这一假设,诊断只能以一定的概率得到证实或被排除。明确的诊断决定可被视为这种诊断决定情况的临界案例。借助四格表及其相关图表对其前提条件进行了解释。如果不具备这些条件,以至于只能做出可能的诊断,那么这些指标有助于评估证据的确定程度。通过统计模型可以获得辅助诊断决定的方法。借助图表对贝叶斯定理的例子进行了说明。近年来,另一种方法正逐渐兴起。所讨论的这些方法是所谓的过程分析的模糊方法。它们主要依靠专家评估和程序化方法。

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