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The diagnostic dartboard: is the bullseye a correct pathoanatomical diagnosis or to guide treatment?
  1. S I Docking1,2,
  2. J Cook1,2,
  3. E Rio1,2
  1. 1 La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
  2. 2 Australian Centre for Research into Injury in Sports and Its Prevention, Federation University, Australia
  1. Correspondence to S I Docking, La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia; sean.docking{at}monash.edu

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It is a very human trait to try and rationalise our complicated world by placing things into distinct groups. There are countless examples where this is the case; good and evil, believers and non-believers, the politically left and right. While it aids our decision-making process, there are some negatives in classifying the world in this way, especially in sports medicine.

Diagnosis of conditions/diseases in patients is the cornerstone of clinical sports medicine. Every clinician aims to take an extensive history and perform clinical tests to accurately diagnose the condition, and then to prescribe the most appropriate intervention. A number of publications have quantified the accuracy (number of correct diagnoses, both negative and positive for the condition, divided by the total number of participants), sensitivity (number of positive diagnoses correctly identified divided by the total number of positive participants) and specificity (number of negative diagnoses correctly identified divided by the total number of negative participants) of various clinical tests in a multitude of conditions. However, the majority of these studies need to be viewed with caution due to a number of methodological issues.

Limitations of current dogma relating to test accuracy

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