Information content of diagnostic tests in the medical literature. 1990

P S Heckerling
Dept. of Medicine, Univ. of Illinois, Chicago.

Diagnostic tests provide information about the presence or absence of disease. However, even after application of diagnostic tests, significant uncertainty about the state of the patient often remains. This uncertainty can be quantified through the use of information theory. The "information" contained in diagnostic tests published in the medical literature of the years 1982 through 1986 was evaluated using Shannon information functions. Information content, averaged over all prior probabilities of disease, ranged from 0.002 bits to 0.720 bits of information; the tests therefore provided from 0.3% to 100% of the information needed for diagnostic certainty. Median average information was 0.395 bits, corresponding to only 55% of the information required for diagnostic certainty. Reclassifying test results into multiple mutually exclusive outcome categories allowed extraction of a median of 14% and a maximum of 109% more average information than that obtained using a dichotomous positive/negative classification. We conclude that the "information" provided by many of the tests published in the medical literature is insufficient to overcome diagnostic uncertainty. Information theory can quantify the uncertainty associated with diagnostic testing and suggest strategies for reducing this uncertainty.

UI MeSH Term Description Entries
D007257 Information Theory An interdisciplinary study dealing with the transmission of messages or signals, or the communication of information. Information theory does not directly deal with meaning or content, but with physical representations that have meaning or content. It overlaps considerably with communication theory and CYBERNETICS. Information Theories,Theories, Information,Theory, Information
D008432 Mathematical Computing Computer-assisted interpretation and analysis of various mathematical functions related to a particular problem. Statistical Computing,Computing, Statistical,Mathematic Computing,Statistical Programs, Computer Based,Computing, Mathematic,Computing, Mathematical,Computings, Mathematic,Computings, Mathematical,Computings, Statistical,Mathematic Computings,Mathematical Computings,Statistical Computings
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012984 Software Sequential operating programs and data which instruct the functioning of a digital computer. Computer Programs,Computer Software,Open Source Software,Software Engineering,Software Tools,Computer Applications Software,Computer Programs and Programming,Computer Software Applications,Application, Computer Software,Applications Software, Computer,Applications Softwares, Computer,Applications, Computer Software,Computer Applications Softwares,Computer Program,Computer Software Application,Engineering, Software,Open Source Softwares,Program, Computer,Programs, Computer,Software Application, Computer,Software Applications, Computer,Software Tool,Software, Computer,Software, Computer Applications,Software, Open Source,Softwares, Computer Applications,Softwares, Open Source,Source Software, Open,Source Softwares, Open,Tool, Software,Tools, Software

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