The New England journal of medicine
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The physician's estimate of the probability that a patient has a particular disease is a principal factor in the determination of whether to withhold treatment, obtain more data by testing, or treat without subjecting the patient to the risks of further diagnostic tests. Using the concepts of decision analysis, we have derived expressions for two threshold probabilities involved in this choice: a "testing" threshold and a "test-treatment" threshold. ⋯ The test should be performed (with treatment depending on the test outcome) only if the probability of disease is between the two thresholds. The method exposes important principles of decision making and helps the clinician develop a rational, quantitative approach to the use of diagnostic tests.
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The MB system is a newly defined system of B-cell alloantigens closely associated with HLA-DR. We assessed the role of MB compatibility in renal transplantation in a retrospective study of 21 patients who had received a kidney transplant from a related donor matched for a single HLA haplotype. ⋯ The association between MB compatibility and allograft acceptance was highly significant (P = 4.4 x 10(-5)), but no significant relation could be demonstrated between transplant survival and donor-recipient compatibility for antigens of the HLA-A, B or DR loci. These findings suggest that match matching for MB may be critical for the selection of donors in intrafamilial kidney transplantation.