Drs Young and Couch unfortunately have missed most of the central points made in our article. As we stressed, the value of most diagnostic tests depends on the specific patient group to which it is applied, as well as when and how it is applied. This is particularly true in the case of a dynamic disorder like deep venous thrombosis, which occurs in such diverse patient groups. Tests with "false-negatives" (are there any which are "perfect"?) cannot be dismissed as "of no use." Such a narrow view would mean we must abandon many useful diagnostic tests, such as the chest x-ray and ECG. Lacking the perfect test in most instances, the important question physicians must answer is this: what are the conditions that make a "false-negative" test likely? Here is the corollary question: when is it necessary to proceed to more invasive, risky, and complex tests that may
Moser KM. Deep Venous Thrombosis-Reply. JAMA. 1977;238(14):1502. doi:10.1001/jama.1977.03280150072027
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