Our Stubborn Quest for Diagnostic Certainty

Abstract

Absolute certainty in diagnosis is unattainable, no matter how much information we gather, how many observations we make, or how many tests we perform. A diagnosis is a hypothesis about the nature of a patient's illness, one that is derived from observations by the use of inference.1 2 3 As the inferential process unfolds, our confidence as physicians in a given diagnosis is enhanced by the gathering of data that either favor it or argue against competing hypotheses. Our task is not to attain certainty, but rather to reduce the level of diagnostic uncertainty enough to make optimal therapeutic decisions.4 5 6 7 Testing is . . .