Entropy removal of clinical features

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.

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Publication Details

Journal
Scientific Reports
Published
2025-11-23
DOI
https://doi.org/10.1038/s41598-025-29069-0
Primary Topic
Clinical Reasoning and Diagnostic Skills
Type
article
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article

Entropy removal of clinical features

Adriana Coleska, Ahmad Hassan, P. Andrew Chong, David Liebovitz et al.
Scientific Reports
Clinical Reasoning and Diagnostic Skills
article

Entropy removal of clinical features

Adriana Coleska, Ahmad Hassan, P. Andrew Chong, David Liebovitz, Brian W. Locke, Kian D. Samadian, Shuhan He, Cory Rohlfsen, Emma Chua
article en

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.

Scientific ReportsVol. 15(1)
Pasadena City College (US), Northwestern University (US), Nebraska Medical Center (US), Walter Reed National Military Medical Center (US), Intermountain Medical Center (US), Massachusetts General Hospital (US), Reed Medical (United Kingdom) (GB), Arie Crown Hebrew Day School (US), University of Nebraska Medical Center (US)
Openalex Percentile: Top 59%
Clinical Reasoning and Diagnostic Skills
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Entropy removal of clinical features — Adriana Coleska, Ahmad Hassan, et al. · Scientific Reports (2025) | TGRS Research Map | TGRS