Variability in Diagnostic Probability Estimates
Authors: Milo A. Puhan, Johann Steurer, Lucas M. Bachmann, Gerben ter Riet
Journal: Annals of Internal Medicine (2004)

Letters5 October 2004Variability in Diagnostic Probability EstimatesMilo A. Puhan, MD, Johann Steurer, MD, MME, Lucas M. Bachmann, MD, PhD, and Gerben ter Riet, MD, PhDMilo A. Puhan, MDFrom Horten Centre, University of Zurich, 8091 Zurich, Switzerland and Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.Search for more papers by this author, Johann Steurer, MD, MMEFrom Horten Centre, University of Zurich, 8091 Zurich, Switzerland and Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.Search for more papers by this author, Lucas M. Bachmann, MD, PhDFrom Horten Centre, University of Zurich, 8091 Zurich, Switzerland and Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.Search for more papers by this author, and Gerben ter Riet, MD, PhDFrom Horten Centre, University of Zurich, 8091 Zurich, Switzerland and Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-7-200410050-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Diagnostic probability estimates are pivotal to the practice of medicine. Patients are entitled to receive justifiable diagnostic probabilities regardless of the physician they consult (1). It is believed that experienced physicians can accurately estimate the likelihood of different illnesses given a set of illness manifestations (2). However, this belief has rarely been tested empirically.Objective: To assess interphysician variability in diagnostic probability estimates for 6 common illnesses early in the diagnostic process.Methods and Findings: We surveyed 183 Swiss primary care physicians attending a conference on continuing medical education. The physicians had received at least 5 ...References1. Miettinen OS. The modern scientific physician: 7. Theory of medicine. CMAJ. 2001;165:1327-8. [PMID: 11760978] MedlineGoogle Scholar2. Sackett DL, Haynes B, Guyatt G, Tugwell P. The interpretation of diagnostic data.. In: Sackett D, Haynes RB, Guyatt GH, eds. Clinical Epidemiology. A Basic Science for Clinical Medicine. 2nd ed. Boston: Little, Brown; 1994:100. Google Scholar3. Okkes IM, Oskam SK, Lamberts H. The probability of specific diagnoses for patients presenting with common symptoms to Dutch family physicians. J Fam Pract. 2002;51:31-6. [PMID: 11927060] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Milo A. Puhan, MD; Johann Steurer, MD, MME; Lucas M. Bachmann, MD, PhD; Gerben ter Riet, MD, PhDAffiliations: From Horten Centre, University of Zurich, 8091 Zurich, Switzerland and Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCommon things are common, but what is common? Incorporating probability information into differential diagnosisWhen Alternative Diagnoses Are More Likely Than Pulmonary Embolism: A ParadoxUrologists' referral attitude for sacral neuromodulation for treating refractory idiopathic overactive bladder syndrome: Discrete choice experimentClinical diagnosis of acute bacterial rhinosinusitis, typical of expertsVignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic reviewClinical diagnosis of pneumonia, typical of expertsWe should overcome the barriers to evidence-based clinical diagnosis!A Randomized Trial of Ways To Describe Test Accuracy: The Effect on Physicians' Post-Test Probability EstimatesMilo A. Puhan, MD, Johann Steurer, MD, MME, Lucas M. Bachmann, MD, PhD, and Gerben ter Riet, MD, PhDAnnals 2004–2005: A Peek Back and a Look ForwardThe Editors 5 October 2004Volume 141, Issue 7Page: 578-579KeywordsDatabasesDiagnostic medicineImaging techniquesMedical educationPatientsPrimary care physiciansQuestionnairesResearch laboratories ePublished: 5 October 2004 Issue Published: 5 October 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...