PubMed · 11165720
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J Thornton, J van Lith. 2001. Decision analysis.. https://doi.org/10.1016/s0301-2115(00)00537-6
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Habitual snoring needs to be taken seriously, both as a symptom of other sleep disorders and as a condition in its own right. GPs approached by patients with problematic snoring face a dilemma regarding whether (and to which service) those patients should be referred for a specialist opinion. Using the Sparks Chart, snoring patients can be grouped according to the two symptomatic dimensions of excessive daytime sleepiness and nocturnal hypoxaemia. We believe that the approach outlined in this article offers GPs a coherent and pragmatic guideline for referring and/or managing problematic snoring by using a simple questionnaire and pulse oximetry. The method has the potential to improve primary and secondary liaison. Most importantly, it offers patients a straight path to treatment.
This article has briefly introduced the dental clinician to the principles and practical application of diagnostic decision analysis. There are trade-offs and uncertainties in the process of arriving at a diagnosis, but they can be understood and controlled. First, the clinician must understand the significance of disease prevalence and assign to the patient an initial probability of disease being present. The clinician must then determine if further diagnostic measurements or tests are warranted. If so, the appropriate test must be selected, based on the ability of the test to revise the initial pretest probability. When a diagnostic test is positive, the clinician must know the probability that disease is actually present. The clinician must also know the probability that disease is actually present if the test result is negative. The astute clinician will calculate the posttest probabilities before proceeding with a test and will base treatment decisions on test results in accordance with predetermined test and test-treatment thresholds.
With the growing need for documented efficacy of treatment and efficiency of rendering care, prosthodontists will serve their patients best when they fully understand the intricacies of clinical research and the results reported. This article proposes a structure for evaluating the literature that pertains to prognosis--the prediction of outcomes and frequency of such occurrences.