Publications

Tests of treatment are commonly used when the diagnosis is uncertain, but can have pitfalls. The accompanying article (doi:10.1136/bmj.b1218) gives an example of how test of treatment can be used.

The first 150 words of the full text of this article appear below.

Though ideally we should have a clear diagnosis before starting treatment, such certainty is not always possible. Sometimes this uncertainty can be resolved by using the treatment as the test that confirms the diagnosis.1 For example, if we are unsure if a patient’s airway obstruction has a reversible element, a trial of steroids can test this: a sufficient response is then considered evidence of reversibility. At other times the test of treatment is not planned, but the failure to respond to treatment as expected leads to a rethink of the diagnosis. In this brief review we discuss different uses of the "test of treatment," its reliability as a diagnostic tool, and how its use might be improved (for a specific example of its use, see the accompanying article on chronic cough2).

As illustrated in figure 1Go, a "test of treatment" is one strategy for the final stage of ...