Interpreting Hoofbeats: Can Bayes Help Clear the Haze?

Abstract
The physician of a 59-year-old man with a long history of mild, labile hypertension became concerned when, despite drug therapy, the patient's blood pressure remained persistently elevated, reaching levels as high as 180/120 mm Hg. He ordered a test of urinary vanilmandelic acid (VMA) excretion and was surprised when he received a report of 20.9 mg per day, a value twice the upper limit of normal.VMA is the end product of catecholamine metabolism, and its excretion is increased in a large proportion of patients with pheochromocytomas. When we collect 24-hour urine samples for VMA in hypertensive patients, especially those . . .

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