What's new in the other general journals

doi:10.1136/bmj.331.7513.369

From trainee to consultant, BMJ Group offers doctors around the world tailored information, special events, learning resources and recruitment services at every step along their career path.

... by doctors, for doctors, for patients
We are open for entries!

Online learning

BMJ Learning

High-quality CME / CPD for doctors and other healthcare professionals. BMJ Learning features hundreds of accredited, peer-reviewed learning modules in text, video, and audio formats. Find out more

Courses and Qualifications

BMJ Masterclasses

BMJ Masterclasses, led by experts, help clinicians to use the latest evidence and recent guidelines in practice and meet their CPD/CME requirements. Find out more

Exam Preparation

The leading provider of online exam preparation, helping over 167,000 healthcare professionals to pass their exams. Find out more

onExamination

Search all BMJ research articles:

From

Limit by

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

Christopher Martyn, associate editor (cmartyn@bmj.com)

How information on the performance of diagnostic tests is presented doesn't seem to matter

There's something of an industry among evidence based medicine experts in devising ways to present to practising clinicians numerical information on the performance of diagnostic tests. How useful they are in everyday practice is another matter. In a randomised experiment at a continuing medical education conference, 183 physicians were asked to estimate probabilities of common illnesses from vignettes of six patients. Each vignette described the symptoms and risk profile of the patient and contained the result of a commonly used diagnostic test. The accuracy of the test was described either in terms of sensitivity and specificity or as a likelihood ratio or as a simple graphic representation of the likelihood ratio. Participating doctors were randomly allocated to receive one of these descriptions.

Differences in estimates of the probability of disease between the groups assigned to different presentations were very small after the test. The authors admit that their findings are preliminary but think that presenting test performance as a likelihood ratio does not have much influence on the way doctors interpret the results. Another possibility, of course, is that clinicians are so familiar with the business of applying the results of diagnostic tests to patient management that they simply do not need these heuristics.

Annals of Internal Medicine2005;143:184-9

OpenUrl FREE Full Text

Mortality in people with end stage renal disease depends on method of dialysis

People with end stage renal disease may receive treatment with either peritoneal dialysis or haemodialysis. Which is better? In the absence of data from randomised controlled trials, we cannot know for sure, but follow-up of a large group of such patients found that mortality was higher in those receiving peritoneal dialysis, although the difference became statistically significant only during the second year of treatment.

More than 1000 patients at 81 centres in 19 states of the United States took part. A quarter of the patients receiving peritoneal dialysis and 5% of those receiving haemodialysis switched methods …