Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Nov 23.
doi: 10.1038/s41598-025-29069-0. Online ahead of print.

Entropy removal of clinical features

Kian D Samadian  1 , Emma Chua  2 , Boyu Peng  3 , Adriana Coleska  4 , Ahmad Hassan  4 , Paul Chong  5 , Brian Locke  6 , David M Liebovitz  7 , Cory Rohlfsen  8 , Shuhan He  4
Affiliations
Free article

Entropy removal of clinical features

Kian D Samadian et al. Sci Rep. .
Free article

Abstract

Interpreting clinical findings is fundamental to diagnosis and care. However, the contribution of individual features to reducing diagnostic uncertainty remains unclear. Information theory's Shannon entropy offers a way to quantify how much a finding narrows diagnostic possibilities. We analyzed 405 symptoms, physical signs, demographic factors, and tests drawn from 23 reviews to calculate entropy reduction from diagnostic tables and compared them to established accuracy measures, including Youden's index and predictive values. Most features yielded modest uncertainty reductions, with nearly half removing less than one-fifth of uncertainty, while a subset of high-performance findings reduced uncertainty by more than 40%. Entropy reduction correlated strongly with Youden's index and positive predictive value. Entropy analysis may enhance evaluation by highlighting features that offer greater informational benefit.

Keywords: Clinical decision-making; Diagnostic performance; Diagnostic uncertainty; Information theory; Shannon entropy; Youden’s index.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

References

    1. Guyatt, G. et al. Evidence-based medicine: A new approach to teaching the practice of medicine. JAMA 268, 2420–2425 (1992).
    1. Kohn, K. T., Corrigan, J. M. & Donaldson, M. S. To Err Is Human: Building a Safer Health System (National Academy Press, 1999).
    1. Agency for Healthcare Research and Quality. AHRQ National Scorecard on Hospital-Acquired Conditions Updated Baseline Rates and Preliminary Results 2014–2017 (Agency for Healthcare Research and Quality, 2019).
    1. Newman, T. B. & Kohn, M. A. Evidence-Based Diagnosis: An Introduction to Clinical Epidemiology (Cambridge University Press, 2020).
    1. Bartol, T. Thoughtful use of diagnostic testing: making practical sense of sensitivity, specificity, and predictive value. Nurse Practit. 40, 10–12 (2015).

LinkOut - more resources