With continued specialization in diagnostic radiology and imaging technology, it increasingly becomes important for diagnostic radiologists to focus on the science of diagnosing disease. Imaging modalities provide a means to examine patients; however, it is the detection of imaging signs (Roentgen signs) that constitutes imaging tests. All tests are subject to error, and the degree of error cannot be determined by clinical experience alone. Therefore, measurements of diagnostic accuracy are important. Accuracy estimates are greatly influenced by selection of the decision criterion and sample population. This article reviews some of the principles for assessing diagnostic accuracy in medical imaging, which is helpful for deciding what tests to perform and how to interpret results once a test has been performed.
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