Dr Baron incorrectly makes an analogy between the clinical evaluation of a patient and the chemical measurement of a drug concentration in a biologic sample. Assessment of a human being—an overwhelmingly complex organism—requires application of scientific principles together with intuition, instinct, and experience. The variables are so numerous that no two physicians would go about it in exactly the same way, and in many cases two informed and reasonable physicians would come to different conclusions. Quantitation of drug concentrations in plasma is a different matter. There is no ambiguity, uncertainty, or room for evaluation or interpretation. There is one and only one correct value of a given drug concentration in a given sample. A chemical analysis either provides or does not provide the correct value (within specified limits). Proficiency testing of analytic laboratories, using both blind and nonblind testing procedures, is a widely accepted and important component of
Friedman H, Greenblatt DJ. Who Should Test the Testers?-Reply. JAMA. 1987;257(8):1051. doi:10.1001/jama.1987.03390080041024
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