Burke M D
Postgrad Med. 1981 Feb;69(2):191-202. doi: 10.1080/00325481.1981.11715687.
The increased utilization of diagnostic procedures has prompted interest in cost-effective laboratory testing. Clinically useful tests-useful in the sense that the patient benefits-are cost effective. The choice of test(s) is determined by the risks and benefits of proposed management. In practice, the first step in cost-effective laboratory testing is to define the clinical problem; the next step is to choose the test(s) that minimize the risks of making a false diagnosis. The choice will depend on whether sensitivity, specificity, or both are needed to decrease diagnostic uncertainty to the extent that management does more good than harm.
诊断程序使用的增加引发了对具有成本效益的实验室检测的关注。临床有用的检测——从患者受益的意义上来说有用——就是具有成本效益的。检测项目的选择取决于拟采取治疗措施的风险和益处。在实践中，具有成本效益的实验室检测的第一步是明确临床问题；下一步是选择能将误诊风险降至最低的检测项目。这种选择将取决于是否需要敏感性、特异性或两者兼具，以便将诊断不确定性降低到治疗利大于弊的程度。
