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Related Experiment Videos

The importance of considering single testing when two tests are available.

J C Hershey1, R D Cebul, S V Williams

  • 1Leonard Davis Institute of Health Economics, Department of Decision Sciences, Wharton School, Philadelphia, Pennsylvania.

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|October 1, 1987
PubMed
Summary

Choosing between single and multiple diagnostic tests depends on disease probability. Research shows that using two tests is not always better than one, irrespective of how tests are combined (parallel or series).

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Area of Science:

  • Medical diagnostics
  • Clinical decision-making
  • Biostatistics

Background:

  • Diagnostic tests are crucial for treatment decisions.
  • The utility of combining diagnostic tests is often evaluated.
  • Pretest probability significantly influences diagnostic accuracy.

Purpose of the Study:

  • To evaluate the optimal strategy for using two dichotomous diagnostic tests in combination.
  • To determine if combined testing is superior to single testing across all disease probabilities.
  • To analyze the impact of test ordering (parallel vs. series) on decision-making.

Main Methods:

  • Mathematical modeling of diagnostic test performance.
  • Analysis of test combinations under varying pretest probabilities.

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  • Comparison of single versus dual-test strategies.

    • Main Results:

    • The optimal choice between single and multiple tests is dependent on the pretest probability of disease.
    • Two tests are not universally superior to a single test for all disease probabilities.
    • The arrangement of tests (parallel or series) does not guarantee preference for dual testing.

    Conclusions:

    • Single diagnostic tests can be sufficient and sometimes preferable to combined approaches.
    • Clinical decisions should carefully consider pretest probability when selecting diagnostic strategies.
    • The findings challenge the assumption that more tests are always better for treatment decisions.