ATR 330
· When positive, can strongly suggest a particular condition
· When negative, do not necessarily rule out the condition - ✔✔What do positive and
negative tests do/mean?
o Only use the literature
§ Pro: Excellent work exists identifying clinical utility of most tests
§ Con: if it's in print in must be true
o Only use your preferences
§ Pro: part of being a clinician is science but also art
§ Con: enters bias into the equation - ✔✔What are the different approaches to special
testing and how do we select them?
o Patient values
§ What are the complaints: anatomical, functional, both?
o Clinician experience
§ what have you seen and what have you used in the past?
o Best available evidence
§ What does the literature tell you and how good is it (quality)? - ✔✔What are the 3
components of evidence-based medicine?
- proportion of patients with the disorder who have a positive test
§ SnNOUT- tests with high sensitivity are useful when result is negative to rule-out the
disorder
§ Good for ruling out(screening) the disorder
§ High values best, but not set threshold
· Remember: the higher the sensitivity, the better chance of ruling out diagnosis when
the test negative - ✔✔Sensitivity
-proportion of patients without the disorder who have a negative test
· SpPin= test with high specificity is useful when results are positive to rule-in disorder
· Good for dx (ruling in) the disorder
· High values best, but not set threshold
· When positive, can strongly suggest a particular condition
· When negative, do not necessarily rule out the condition - ✔✔What do positive and
negative tests do/mean?
o Only use the literature
§ Pro: Excellent work exists identifying clinical utility of most tests
§ Con: if it's in print in must be true
o Only use your preferences
§ Pro: part of being a clinician is science but also art
§ Con: enters bias into the equation - ✔✔What are the different approaches to special
testing and how do we select them?
o Patient values
§ What are the complaints: anatomical, functional, both?
o Clinician experience
§ what have you seen and what have you used in the past?
o Best available evidence
§ What does the literature tell you and how good is it (quality)? - ✔✔What are the 3
components of evidence-based medicine?
- proportion of patients with the disorder who have a positive test
§ SnNOUT- tests with high sensitivity are useful when result is negative to rule-out the
disorder
§ Good for ruling out(screening) the disorder
§ High values best, but not set threshold
· Remember: the higher the sensitivity, the better chance of ruling out diagnosis when
the test negative - ✔✔Sensitivity
-proportion of patients without the disorder who have a negative test
· SpPin= test with high specificity is useful when results are positive to rule-in disorder
· Good for dx (ruling in) the disorder
· High values best, but not set threshold
