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September 6, 1985

Physicians Poor at Prevalence and Positive Predictive Value

Author Affiliations

Dana-Farber Cancer Institue Boston ersity of Washington Seattle

JAMA. 1985;254(9):1173-1174. doi:10.1001/jama.1985.03360090063013

To the Editor.—  In 1978, Casscells et al1 reported the findings of a survey concerned with physician appreciationthe limitations of laboratory testtesting in the process of clinical decinsion. Physicians have generallyrmed poorly on tests assaying the use of quantitative informinformation.1,2 A large number licati-nsng decision theory tenets such as tetenets such as test ificity,sitive p-edictive valupositive predictive have subsequently3,4redappeared.3,4 study of clinical decisions has become a fundable research toptopic, athe utilization of Bayes' thetheorem in clinical settings is discussed in the curricula most medical schools. We estim-te that oneone articlech month, requiring some rudrudimentaryowle-ge of decision thetheory and/or Bayes' theorem in order to be properly analyzed,blished in one of the mathe major medical journals.We asked whether increasing exposure to concepts of decision theory in medical school, postgraduate training, in the medical literature might be associated with improved results on a question requiring appreciation of a