title: Clinical judgment to estimate pretest probability in the diagnosis of Cushing's syndrome under a Bayesian perspective.
abstract: OBJECTIVE
  To estimate the pretest probability of Cushing's syndrome (CS) diagnosis by a Bayesian approach using intuitive clinical judgment.
  
  
  METHODS
  Physicians were requested, in seven endocrinology meetings, to answer three questions: "Based on your personal expertise, after obtaining clinical history and physical examination, without using laboratorial tests, what is your probability of diagnosing Cushing's Syndrome?"; "For how long have you been practicing Endocrinology?"; and "Where do you work?". A Bayesian beta regression, using the WinBugs software was employed.
  
  
  RESULTS
  We obtained 294 questionnaires. The mean pretest probability of CS diagnosis was 51.6% (95%CI: 48.7-54.3). The probability was directly related to experience in endocrinology, but not with the place of work.
  
  
  CONCLUSIONS
  Pretest probability of CS diagnosis was estimated using a Bayesian methodology. Although pretest likelihood can be context-dependent, experience based on years of practice may help the practitioner to diagnosis CS.
authors: FMRP, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
authors: Daniel E
authors: DE
authors: Cipoli
authors: Edson Z
authors: EZ
authors: Martinez
authors: Margaret de
authors: Md
authors: Castro
authors: Ayrton C
authors: AC
authors: Moreira
mesh_terms: D001499:Bayes Theorem; D002983:Clinical Competence; D003226:Congresses as Topic; D003480:Cushing Syndrome / Q000175:diagnosis*; D004704:Endocrinology / Q000592:standards*; D006801:Humans; D007600:Judgment; D016015:Logistic Models; D008962:Models, Theoretical; D011336:Probability; D011795:Surveys and Questionnaires