title: Test selection in jaundice: a comparison between physician behavior and a diagnostic model.
abstract: The results of an observational study aimed at a formal assessment of clinicians' test-selection behavior are presented. We first make a proposal for diagnostic test usage in the latter phases of jaundice diagnosis. Next we compute a probabilistic estimate of the patient diagnosis, based on the COMIK algorithm. From the proposal and the probabilistic estimate we can predict the "test-selection behavior" of clinicians. The assessment follows from a tabulation of the predicted behavior against the tests selected by clinicians. It is shown that for most tests, the predictions are consistent with the observed test-selection behavior at a statistically significant level. Discussions of discrepancies between prediction and observation, and reasons for deviations from general guidelines, provide new dimensions for medical education. The methodology applied is a useful tool to improve medical care for the jaundiced patient.
authors.affiliation: Institute of Public Health and Social Medicine, Erasmus University, Rotterdam, The Netherlands.
authors.forename: R W
authors.initials: RW
authors.lastname: Segaar
authors.forename: J H
authors.initials: JH
authors.lastname: Wilson
authors.forename: J D
authors.initials: JD
authors.lastname: Habbema
mesh_terms: D000465:Algorithms; D003657:Decision Making; D006801:Humans; D007565:Jaundice / Q000175:diagnosis*; D015233:Models, Statistical; D011336:Probability