To Test or Not to Test II: The Value of Imperfect Information

In this video, Professor Myriam Hunink asks students to think beyond a decision to treat or not to treat, and to consider a third alternative or option - to test and get more information. In this case, the test information is assumed to be imperfect.

Access the video. To Test or Not to Test II: The Value of Imperfect Information (~20 min)

Professor Hunink shares the story of a colleague who was at the recommended age for colon cancer screening with a colonoscopy. As a radiologist, he preferred a CT virtual colonoscopy to avoid the endoscopic procedure. Although no abnormal findings were detected in the colon, other abnormalities were revealed in other organs. What should the clinician responsible do? In essence, there are three alternatives - take action, do not take action, and get more information.

Leveraging this example, Professor Hunink graphically illustrates thresholds for a test that delivers imperfect information. Students are reminded of the influential factors in clinical decision making, such as the prior probability of disease, the benefits of treatment, and the harms of treatment - and in this context, they now also consider test characteristics and the consequences of the false positives compared with the true negatives (i.e., potential harms), and the consequences of false negatives compared with the true positives (i.e., foregone benefits of treatment).

This video is one of a series developed by Professor Myriam Hunink during an immersion residency at the Center for Health Decision Science (CHDS) Media Hub. The video series reflect experiments to augment brick and mortar teaching with multimedia materials that emphasize visualization of basic concepts.