Uploaded April 2021 | Updated September 2026, 1 week ago
An introductory *qualitative* discussion of the threshold model of clinical decision-making, including the definitions of "rule in" and "rule out" as it pertains to establishing or eliminating diagnostic possibilities.
For more reading about the threshold model:
Pauker SG, Kassirer JP. The threshold approach to clinical decision making. NEJM. 1980;302:1109-17. (pubmed.ncbi.nlm.nih.gov/7366635/)
Djulbegovic B, et al. When is rational to order a diagnostic test, or prescribe treatment: the threshold model as an explanation of practice variation. Eur J Clin Invest. 2015;45:485-93. (pubmed.ncbi.nlm.nih.gov/25675907/)
Djulbegovic B, et al. The threshold model revisited. J Eval Clin Pract. 2019; 25:186-195. (onlinelibrary.wiley.com/doi/10.1111/jep.13091)
For more reading about diagnosing UTIs:
Bent, S, et al. Does this woman have an acute uncomplicated urinary tract infection? JAMA. 2002;287:2701-10. (pubmed.ncbi.nlm.nih.gov/12020306/)
Deville, W, et al. The urine dipstick test useful to rule out infections. A meta-analysis of the accuracy. BMC Urol. 2004;4:4. (pubmed.ncbi.nlm.nih.gov/15175113/)
Lammers RL, et al. Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points. Ann Emerg Med. 2001;38:505-12. (pubmed.ncbi.nlm.nih.gov/11679861/)
An introductory *qualitative* discussion of the threshold model of clinical decision-making, including the definitions of "rule in" and "rule out" as it pertains to establishing or eliminating diagnostic possibilities.
For more reading about the threshold model:
Pauker SG, Kassirer JP. The threshold approach to clinical decision making. NEJM. 1980;302:1109-17. (pubmed.ncbi.nlm.nih.gov/7366635/)
Djulbegovic B, et al. When is rational to order a diagnostic test, or prescribe treatment: the threshold model as an explanation of practice variation. Eur J Clin Invest. 2015;45:485-93. (pubmed.ncbi.nlm.nih.gov/25675907/)
Djulbegovic B, et al. The threshold model revisited. J Eval Clin Pract. 2019; 25:186-195. (onlinelibrary.wiley.com/doi/10.1111/jep.13091)
For more reading about diagnosing UTIs:
Bent, S, et al. Does this woman have an acute uncomplicated urinary tract infection? JAMA. 2002;287:2701-10. (pubmed.ncbi.nlm.nih.gov/12020306/)
Deville, W, et al. The urine dipstick test useful to rule out infections. A meta-analysis of the accuracy. BMC Urol. 2004;4:4. (pubmed.ncbi.nlm.nih.gov/15175113/)
Lammers RL, et al. Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points. Ann Emerg Med. 2001;38:505-12. (pubmed.ncbi.nlm.nih.gov/11679861/)
