Qualitative probability versus quantitative probability in clinical diagnosis: a study using a computer simulation.

The use of Bayes' theorem as a diagnostic tool in clinical medicine normally requires an input of exact probability estimates. However, humans tend to think in categories ("likely," "unlikely," etc.) rather than in terms of exact probability. A computer simulation of the presenting features of a case of pelvic infection has been used to compare the effects of quantitative and qualitative probability estimates on the diagnostic accuracy of Bayes' theorem. For the commoner conditions (prior probability greater than or equal to 0.2) the use of a two- or three-category system is virtually equivalent to the use of exact probability. However, uncommon conditions (prior probability less than or equal to 0.03) are completely ignored by the qualitative system. It is concluded that the use of simple categories of probability is acceptable for a Bayesian diagnostic system provided that the target conditions have a relatively high prior probability.