Variance and Dissent: The Comprehensive Diagnostic Study
- The classical diagnostic cross-sectional study has a focus on one disease only. Generalist clinicians, however, are confronted with a wide range of diagnoses. We propose the “comprehensive diagnostic study design” to evaluate diagnostic tests regarding more than one disease outcome.
- We thank Ann Van den Bruel and Rafael Perera for their thoughtful commentary  on our proposal regarding the comprehensive diagnostic study (CDS) design . They have highlighted some of the difficulties to be expected with this study type.
- We would like to thank Donner-Banzhoff et al. for their thoughtful and careful response to our commentary.
- Diagnostic labeling is one of the key elements of clinical care. The diagnostic label is used to explain symptoms, initiate appropriate treatment, or provide prognostic information . Choosing the correct diagnostic label based on the available diagnostic information can be challenging. Especially in primary care, which is the first contact setting for an unselected patient population, the clinician is left to choose from a large list of diagnostic possibilities. A patient presenting with chest pain may suffer from an acute coronary syndrome, hyperventilation, esophagitis, muscle pain, or pulmonary embolism .