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R W Sappenfield

Publications and source records attributed to R W Sappenfield.

18 recordsLinked to original sources
PubMed1981

Nine-cell diagnostic decision matrix. A model of the diagnostic process; a framework for evaluating diagnostic protocols.

A nine-cell diagnostic decision matrix is described. This matrix can be viewed dynamically as a model of the diagnostic process. The matrix provides for display of equivocal test results and test results of patients who have ill-defined or incompletely determined disease. The matrix represents an improved model for evaluating diagnostic test protocols. Diagnostic test characteristics related to this model are described. Potential advantages and uses of the model are discussed; among them are possibilities for development of improved diagnostic protocols and improved definitions of disease.

Decision Making↗
PubMed1981

Ranking diagnostic protocols--a proposed process based on use of the nine-cell diagnostic decision matrix.

A process for ranking competing diagnostic protocols for a specific disease is presented. The process incorporates the basic principles of medical decision making, and provides for the consideration of equivocal test results as well as results for patients who have ill-defined or incompletely defined disease. It provides a means for developing an a priori optimization process prior to ranking competing diagnostic algorithms. Methods for transferring ranking information among populations with widely differing disease prevalences are given.

Clinical Laboratory Techniques↗
PubMed1980

Reasonableness of use of the serum isoenzymes creatine kinase and lactate dehydrogenase for the diagnosis of myocardial infarction at a medical center.

At Charity Hospital of Louisiana at New Orleans, in 1978, there was considerable underuse of serum creatine kinase and lactate dehydrogenase isoenzymes for the diagnosis of myocardial infarction. Laboratory generation of creatine kinase isoenzyme tests for patients suspected of having had myocardial infarctions was only partially effective in correcting underuse. It unnecessarily generated some overuse. Appropriate modifications of this policy could improve performance. Additional, effective educational efforts are needed to improve reasonable use of laboratory tests. The study uncovered an unexpected problem in the laboratory--in a significant percentage of cases, results of indicated and ordered tests failed to appear in the charts.

Clinical Enzyme Tests↗