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During the diagnostic process of the various oral and maxillofacial lesions, we should consider the following:When should we order diagnostic tests? What tests should be ordered? How should we interpret the resultsclinically? And how should we use this frequently imperfect information to make optimal medical ecisions? For the clinicians to make proper judgement, several decision making tools are suggested. This article discusses the concept of the diagnostic accuracy (sensitivity and specificity values) with several decision making tools such as decision matrix, ROC analysis and Bayesian analysis. The article also explain the introductory concept of ORAD program. (Korean J Oral Maxillofac Radiol 2006; 36 : 1-5)