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A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic testing, chemical and cellular analysis, relating to clinical chemistry and molecular diagnostics, are typically performed in a medical setting.

Types of tests

By purpose

Medical tests can be classified by their purposes, the most common of which are diagnosis, screening and evaluation.

Diagnostic

Lung scintigraphy evaluating lung cancer

A diagnostic test is a procedure performed to confirm or determine the presence of disease in an individual suspected of having a disease, usually following the report of symptoms, or based on other medical test results.[1][2] This includes posthumous diagnosis. Examples of such tests are:

Screening

Screening refers to a medical test or series of tests used to detect or predict the presence of disease in at risk individuals within a defined group such as a population, family, or workforce.[4][5] Screenings may be performed to monitor disease prevalence, manage epidemiology, aid in prevention, or strictly for statistical purposes.[6]

Examples of screenings include measuring the level of TSH in the blood of a newborn infant as part of newborn screening for Diagnostic

Lung scintigraphy evaluating lung cancer

A diagnostic test is a procedure performed to confirm or determine the presence of disease in an individual suspected of having a disease, usually following the report of symptoms, or based on other medical test results.[1][2] This includes posthumous diagnosis. Examples of such tests are:

Screening

Screening refers to a medical test or series of tests used to detect or predict the presence of disease in at risk individuals within a defined group such as a population, family, or workforce.[4][5] Screenings may be performed to monitor disease prevalence, mana

A diagnostic test is a procedure performed to confirm or determine the presence of disease in an individual suspected of having a disease, usually following the report of symptoms, or based on other medical test results.[1][2] This includes posthumous diagnosis. Examples of such tests are:

  • Using nuclear medicine to examine a patient suspected of having a lymphoma.
  • Measuring the blood sugar in a person suspected of having diabetes mellitus after periods of increased urination.
  • Taking a complete blood count of an individual experiencing a high fever to check for a bacterial infection.[1]
  • Monitoring electrocardiogram readings on a patient suffering chest pain to diagnose or determine any Screening refers to a medical test or series of tests used to detect or predict the presence of disease in at risk individuals within a defined group such as a population, family, or workforce.[4][5] Screenings may be performed to monitor disease prevalence, manage epidemiology, aid in prevention, or strictly for statistical purposes.[6]

    Examples of screenings include measuring the level of TSH in the blood of a newborn infant as part of newborn screening for congenital hypothyroidism,[7] checking for Lung cancer in non-smoking individuals who are exposed to second-hand smoke in an unregulated working environment, and Pap smear screening for prevention or early detection of cervical cancer.

    Monitoring

    Some medical tests are used to monitor the progress of, or response to medical treatment.

    By methodTSH in the blood of a newborn infant as part of newborn screening for congenital hypothyroidism,[7] checking for Lung cancer in non-smoking individuals who are exposed to second-hand smoke in an unregulated working environment, and Pap smear screening for prevention or early detection of cervical cancer.

    Some medical tests are used to monitor the progress of, or response to medical treatment.

    By method

    Most test methods can be classified into one of the following broad groups:

    • Patient observations, which may be photographed or recorded
    • Questions asked

      Most test methods can be classified into one of the following broad groups:

      • Patient observations, which may be photographed or recorded
      • Questions asked when taking an individual's medical history
      • Tests performed in a physical exa

        In vitro tests can be classified according to the location of the sample being tested, including:

        Accuracy and precision

        • Accuracy of a laboratory test is its correspondence with the true value. Accuracy is maximized by calibrating laboratory equipment with reference material and by participating in external quality control programs.
        • Precision of a test is its reproducibility when it is repeated on the same sample. An imprecise test yields widely varying results on repeated measurement. Precision is monitored in laboratory by using control material.

        Detection and quantification

        Tests performed in a physical examination are usually aimed at detecting a symptom or sign, and in these cases, a test that detects a symptom or sign is designated a positive test, and a test that indicated absence of a symptom or sign is designated a negative test, as further detailed in a separate section below.

        A quantification of a target substance, a cell type or another specific entity is a common output of, for example, most blood tests. This is not only answering if a target entity is present or absent, but also how much is present. In blood tests, the quantification is relatively well specified, such as given in mass concentration, while most other tests may be quantifications as well although less specified, such as a sign of being "very pale" rather than "slightly pale". Similarly, radiologic images are technically quantifications of radiologic opacity of tissues.

        Especially in the taking of a medical history, there is no clear limit between a detecting or quantifying test versus rather descriptive info

        Tests performed in a physical examination are usually aimed at detecting a symptom or sign, and in these cases, a test that detects a symptom or sign is designated a positive test, and a test that indicated absence of a symptom or sign is designated a negative test, as further detailed in a separate section below.

        A quantification of a target substance, a cell type or another specific entity is a common output of, for example, most blood tests. This is not only answering if a target entity is present or absent, but also how much is present. In blood tests, the quantification is relatively well specified, such as given in mass concentration, while most other tests may be quantifications as well although less specified, such as a sign of being "very pale" rather than "slightly pale". Similarly, radiologic images are technically quantifications of radiologic opacity of tissues.

        Especially in the taking of a medical history, there is no clear limit between a detecting or quantifying test versus rather descriptive information of an individual. For example, questions regarding the occupation or social life of an individual may be regarded as tests that can be regarded as positive or negative for the presence of various risk factors, or they may be regarded as "merely" descriptive, although the latter may be at least as clinically important.

        Positive or negative

        The result of a test aimed at detection of an entity may be positive or negative: this has nothing to do with a bad blood tests. This is not only answering if a target entity is present or absent, but also how much is present. In blood tests, the quantification is relatively well specified, such as given in mass concentration, while most other tests may be quantifications as well although less specified, such as a sign of being "very pale" rather than "slightly pale". Similarly, radiologic images are technically quantifications of radiologic opacity of tissues.

        Especially in the taking of a medical history, there is no clear limit between a detecting or quantifying test versus rather descriptive information of an individual. For example, questions regarding the occupation or social life of an individual may be regarded as tests that can be regarded as positive or negative for the presence of various risk factors, or they may be regarded as "merely" descriptive, although the latter may be at least as clinically important.

        The result of a test aimed at detection of an entity may be positive or negative: this has nothing to do with a bad prognosis, but rather means that the test worked or not, and a certain parameter that was evaluated was present or not. For example, a negative screening test for breast cancer means that no sign of breast cancer could be found (which is in fact very positive for the patient).[citation needed]

        The classification of tests into either positive or negative gives a binary classification, with resultant ability to perform bayesian probability and performance metrics of tests, including calc

        The classification of tests into either positive or negative gives a binary classification, with resultant ability to perform bayesian probability and performance metrics of tests, including calculations of sensitivity and specificity.[citation needed]

        Tests whose results are of continuous values, such as most blood values, can be interpreted as they are, or they can be converted to a binary ones by defining a cutoff value, with test results being designated as positive or negative depending on whether the resultant value is higher or lower than the cutoff.

        Interpretation

        In the finding of a pathognomonic sign or symptom it is almost certain that the target condition is present, and in the absence of finding a sine qua non sign or symptom it is almost certain that the target condition is absent. In reality, however, the subjective probability of the presence of a condition is never exactly 100% or 0%, so tests are rather aimed at estimating a post-test probability of a condition or other entity.

        Most diagnostic tests basically use a reference group to establish performance data such as predictive values, likelihood ratios and relative risks, which are then used to interpret the post-test pr

        Most diagnostic tests basically use a reference group to establish performance data such as predictive values, likelihood ratios and relative risks, which are then used to interpret the post-test probability for an individual.

        In monitoring tests of an individual, the test results from previous tests on that individual may be used as a reference to interpret subsequent tests.

        Some medical testing procedures have associated health risks, and even require general anesthesia, such as the mediastinoscopy.[14] Other tests, such as the blood test or pap smear have little to no direct risks.[15] Medical tests may also have indirect risks, such as the stress of testing, and riskier tests may be required as follow-up for a (potentially) false positive test result. Consult the health care provider (including physicians, physician assistants, and nurse practitioners) prescribing any test for further information.

        Indications p × r i × ( b i h i ) h t {\displaystyle b_{n}=\Delta p\times r_{i}\times (b_{i}-h_{i})-h_{t}}

        , where:

        Some additional factors that influence a decision whether a medical test should be performed or not included: cost of the test, availability of additional tests, potential interference with subsequent test (such as an abdominal palpation potentially inducing intestinal activity whose sounds interfere with a subsequent abdominal auscultation), time taken for the test or other practical or administrative aspects. The possible benefits of a diagnostic test may also be weighed against the costs of unnecessary tests and resulting unnecessary follow-up and possibly even unnecessary treatment of incidental findings.[16]

        In some cases, tests being performed are expected to have no benefit for the individual being tested. Instead, the results may be useful for the establishment of statistics in order to improve health care for other individuals. Patients may give informed consent to undergo medical tests that will benefit other people.

        Patient expectations

        In addition to considerations of the nature of medical testing noted above, other realities can lead to misconceptions and unjustified expectations among patients. These include: Different labs have different normal reference ranges; slightly different values will result from repeating a test; "normal" is defined by a spectrum along a bell curve resulting from the testing of a population, not by "rational, science-based, physiological principles"; sometimes tests are used in the hope of turning something up to give the doctor a clue as to the nature of a given condition; and imaging tests are subject to fallible human interpretation and can show "incidentalomas", most of which "are benign, will never cause symptoms, and do not require further evaluation," although clinicians are developing guidelines for deciding when to pursue diagnoses of incidentalomas.[17]

        Standard for the reporting and assessment

        The QUADAS-2 revision is available.[18]

        informed consent to undergo medical tests that will benefit other people.

        In addition to considerations of the nature of medical testing noted above, other realities can lead to misconceptions and unjustified expectations among patients. These include: Different labs have different normal reference ranges; slightly different values will result from repeating a test; "normal" is defined by a spectrum along a bell curve resulting from the testing of a population, not by "rational, science-based, physiological principles"; sometimes tests are used in the hope of turning something up to give the doctor a clue as to the nature of a given condition; and imaging tests are subject to fallible human interpretation and can show "incidentalomas", most of which "are benign, will never cause symptoms, and do not require further evaluation," although clinicians are developing guidelines for deciding when to pursue diagnoses of incidentalomas.[17]

        Standard for the reporting and assessment

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