Final answer:
Use 'ref' when you have an initial value for a variable being passed to a method and 'out' when you do not have an initial value or are uncertain of having one.
Step-by-step explanation:
The decision between using ref and out in C# depends on whether or not you have an initial value for the variable you're passing to the method. If you always have an initial value, use ref. This means that the variable must be initialized before it is passed to the method. On the other hand, if you do not have an initial value, or you do not know whether you will have an initial value, use out. The out keyword allows the method to initialize the variable before it returns, and the calling code does not need to initialize it beforehand.