Measures of the value of a diagnostic test derived from stochastic thresholds

Previous indices for measuring the potential impact of a diagnostic test on a physician's management of a given patient were derived based on a fixed threshold model. The authors adapted these indices to a stochastic threshold model. In the stochastic threshold model the physician's probability of treating the patient is a function of the patient's probability of disease. From this model the authors derived the management value index (the expected effect that the test has on the physician's probability for treating the patient) and the utility value index (the expected benefit to the patient if the diagnostic test is used). Graphs of the indices versus the patient's probability of disease may be useful in teaching appropriate use of diagnostic tests.