The major value of this method is that it avoids the binary constraint of a "black or white" decision, which is often inappropriate to clinical or screening practice, in which existing quantitative tests almost never perfectly differentiate between individuals with and without the target condition, and unique cutoff values cannot be found that allow the tests results to simultaneously confirm and exclude diagnostic hypotheses
MHCs in training need to know that when it comes to finding support for one's diagnostic hypotheses, what one looks for determines what one finds.
This exercise provides, therefore, an opportunity for students to identify some of the ways in which their assumptions and biases affect their diagnostic hypotheses.
According to this theory, careful consideration and identification of all histopathologic features present in an image should precede the formation of diagnostic hypotheses
and hence the generation of a diagnosis on the case.
The effects of changing cutoff points, use of odds and likelihood ratios, combination testing, and in particular, the concept of posttest probabilities crossing "thresholds" and thereby confirming or excluding diagnostic hypotheses
are all presented in lucid clinically relevant language.