Probabilities (General)

by romansh , Saturday, April 19, 2014, 15:17 (3870 days ago) @ David Turell

Sometimes that is all it takes: As I have said the average complex diagnosis will have a constellation of factors reviewed and studied. But some diagnoses require just one test. The problem is having to think of the possibility. I had a patient who had enormous bouts of swelling anywhere in the body. Fatal in the larnyx if prolonged. She had been treated with epinephrine by IV and in her thoat. She came to me and luckily I had recently read a case report about "C-1 esterase inhibitor deficiency". At Baylor Med school luckily there was an immunology prof who could run the single test to prove the point which he did. Luckily the research folks studying the condition had devised a treatment to prevent such episodes. 
> 
> I don't think your worry about probabilities in medical practice is much of an issue. You are looking in from the outside and I don't think you fully understand how or what good doctors are capable of doing diagnostically.-I am not specifically worried about the medical profession not knowing probabilities.-But now you come to mention it ... what is the false positive rate for your Baylor Med School prof's test, and what is the incidence of C-1 esterase inhibitor deficiency in the group that displays the symptoms?-And this phrase here ... who could run the single test to prove the point which he did. worries me. Science is not in the proof business. There is always a degree of uncertainty in science. I hope the medical profession displays some uncertainty too.