A Bayesian approach to the accuracy of clinical observations.

The accuracy of clinical observations was estimated using Bayesian latent-class models with two or more independent tests. Four veterinarians carried out systematic independent clinical examinations on 155 pigs in three herds. Based on the results of binary recordings of clinical observations on dullness, poor body condition (PBC), skin lesions, lameness, respiratory disease, and diarrhea, a latent disease state for each clinical disease was estimated using Gibbs sampling. The accuracy of the clinical observations differed for the four observers and for different clinical signs. Population parameters were estimated from a Bayesian hierarchical model, and the accuracy of a random observer was calculated. We concluded that the accuracy of the veterinarians in this study substantiated the need to pursue more-precise definitions of the clinical findings and that larger sample sizes would be needed to provide reasonable variance estimates. Finally, we concluded that the uncertainty in the clinical decision-making process (starting with the clinical examination) needs to be represented fully.