Shapiro A R
N Engl J Med. 1977 Jun 30;296(26):1509-14. doi: 10.1056/NEJM197706302962607.
Clinical predictions are never certain but are inherently probablisitc. The accuracy coefficient, a measure of probabilistic accuracy based on probability assigned to outcomes that occur, was used to assess the skill of clinical rheumatologists in predicting patient outcomes. Physicians' scores correlated well with degree of clinical experience. An approach to evaluation based on the measure provides a sensitive assessment of marginal benefit of technologies such as laboratory tests, diagnostic procedures or computer consultations. Most currently used methods of computer prediction were not as accurate as the best physicians tested. By allowing measurement of ability to individualize predictions to each patient's unique characteristics, the accuracy-coefficient approach has potential use in physician assessment.
临床预测从来都不是确定无疑的，而是本质上具有概率性。准确性系数是一种基于赋予发生结果的概率来衡量概率准确性的指标，被用于评估临床风湿病学家预测患者预后的技能。医生的得分与临床经验程度密切相关。基于该指标的评估方法能够对实验室检查、诊断程序或计算机会诊等技术的边际效益进行灵敏评估。目前大多数计算机预测方法不如接受测试的最佳医生准确。通过允许衡量针对每个患者独特特征进行个性化预测的能力，准确性系数方法在医生评估方面具有潜在用途。
