Controversy and debate: challenges with the need to improve the reference standard in diagnosis paper 1: two challenges: absence of a clear cut, easily replicable test for the reference standard; unethical/infeasible inclusion of an invasive procedure in the reference standard
1 Department of Radiology, Max Rady College of Medicine, University of Manitoba, 197 Harvard Avenue, Winnipeg, Manitoba, Canada R3M 0J9. Electronic address: [email protected].