Increasing diagnostic certainty: the clinical value of the likelihood ratio

The LR has the potential to be a valuable tool to mitigate uncertainty in the diagnostic process for clinicians in any area of medicine. With more and more LRs being published in the literature and the ready availability of the likelihood nomogram, there has never been a better time to put this tool to work in both inpatient and outpatient settings. PA students can be exposed initially to LRs in their diagnostic medicine lectures, followed by application of the principles in case-based exercises in clinical medicine or as part of their evidence-based medicine curriculum. Clinical-year PA students can then be encouraged to use LRs in their clinical rotations as they collaborate with preceptors in the diagnostic decision-making process. Exposure to and application of LRs in the didactic and clinical aspects of the curriculum are likely to increase their comfort level with this valuable tool and enable them to use it with ease in their future clinical practices.