Determine power to detect a misclassification event in rule-out pathways for myocardial infarction

[R_cubed]

Consider the words of wisdom in these blog posts, and maybe the broader medical research community can move away from information destroying practices.

Avoiding One-Number Summaries of Treatment Effects for RCTs with Binary...

Statistically Efficient Ways to Quantify Added Predictive Value of New...

The first link appears most relevant to your question.

For background, 2 additional articles are worth study, which can be found here:

Statistical Misinterpretations and Clinical Practice Guidelines: any examples?

I can’t remember where I found it (probably one of Frank’s reference lists), but this paper on risk prediction as preferable to diagnosis (classification) is really where clinical care needs to go, especially with regulators insisting on health systems that get payments engage in financial risk taking for the care provided. That, in turn, implies that quality assurance and improvement would be involved in the development and implementation of risk prediction (and reduction) models, instead of c…

Addendum: I suspect the medical practitioners are (correctly) concerned with the suspicion that these models are too complicated in practice, where decisions need to be made in a short period of time. A good question for the statisticians and decision theorists would be:

Blockquote
How can probabilistic decision making be adapted to critical situations where there is no time for the physician to consult a model – (ie. emergency medicine), but quick action needs to be taken?