- Two main approaches are used to draw statistical inferences: frequentist and bayesian.
- The frequentist approach dominates the medical literature.
- Clinical decision making is fundamentally bayesian.
- Bayesians interpret the test result not as a probability of a false positive but as the degree to which a positive or negative result adjusts the probability of a given disease.
- In a sense, the bayesian approach asks, “What is the probability that this patient has the disease, given this test result?”
- All clinical history questions and physical examinations constitute diagnostic tests, although their sensitivities and specificities are rarely known precisely.
- Clinicians apply bayesian reasoning in framing and revising differential diagnoses.
- A Bayesian approach is essential for interpreting surprising test results in the context of history taking and physical examination.