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There is a relative scarcity of published papers on validation of assessment for postgraduate medical certification considering the influence these high stakes processes have on doctors career progression and employment opportunities. General and family practice institutions in a number of English speaking countries have set an example to others, by showing that rigour and transparency in assessment development and implementation can be reflected in publication.

We introduce a reduction-based model for analyzing supervised learning tasks. We use this model to devise a new reduction from cost-sensitive classification to binary classification with the following guarantee: If the learned binary classifier has error rate at most then the cost-sensitive classifier has cost at most 2 times the expected sum of costs of all choices. Since cost-sensitve classification can embed any bounded loss finite choice supervised learning task, this result shows that any such task can be solved using a binary classification oracle. Finally, we present experimental results showing that our new reduction outperforms existing algorithms for multi-class cost-sensitive learning. Preliminary work. Under review by the International Conference on Machine Learning (ICML). Do not distribute.

Objective-To examine the traditional view that unawareness of hypoglycaemia and inadequate hypoglycaemic counterregulation in insulin dependent diabetes meilitus are manifestations of autonomic neuropathy.Design-Perspective assessment of unawareness of hypoglycaemia and detailed assessment of autonomic neuropathy in patients with insulin dependent diabetes according to the adequacy of their hypoglycaemic counterregulation.Setting-One routine diabetic unit in a university teaching hospital. IntroductionUnawareness of hypoglycaemia in diabetic patients is, by tradition, ascribed to autonomic neuropathy.'13 Some patients with insulin dependent diabetes mellitus have been shown to produce inadequate amounts of adrenaline and glucagon in response to hypoglycaemia, and these patients are more at risk from neuroglycopenia and hypoglycaemic coma.4 Diabetic autonomic neuropathy has also been suggested as the cause of defective adrenaline secretion in these patients,"7 and, in this way, as the cause of inadequate counterregulation. Previous studies investigating diabetic autonomic neuropathy and inadequate counterregulation have included only limited assessment of autonomic function, giving rise to conflicting results.89 We used an extensive battery of investigations of autonomic neuropathy to re-examine the relations among autonomic neuropathy, hypoglycaemic unawareness, and inadequate hypoglycaemic counterregulation.