Background In clinical and epidemiologic studies one is frequently tasked with maximizing accuracy when assessing the presence of clinical conditions (symptoms, diagnoses, syndromes, etc.) or verifying outcome events such as stroke, myocardial infarction, or death from a specific cause. Prospective studies have the advantage of standardizing definitions of clinical conditions, minimizing bias, and being honest about disagreements about clinical designations. Many studies have clinical endpoin...