Medical Testing

To the Editor.  —I read with interest the article in the March Archives by Pinckney entitled "The Accuracy and Significance of Medical Testing" (1983; 143:512-514).I emphatically agree that before ordering a test procedure a physician should have valid reason for ordering a test. Ideally he should understand the limits of the procedure so that he can properly interpret the results for his patient. He must be able to rely on the testing system he orders.The article proposes that the practicing physician is compromised in his efforts at patient care because "one in seven medical tests are either in error or totally unreliable for clinical application." The author indicates that government surveys of test proficiency document this inadequacy. Both of these statements are incorrect! The basis for the author's comment is a publication in the American Medical News. The author of the article, Dr Joseph Boutwell,¹ offered a