Article on bayesian methods was right

BMJ 1999;319:1573 ( 11 December )

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Article on bayesian methods was right

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EDITOR $---$ Bayes's theorem was invoked in a paper about screening for HIV by Meyer and Pauker in 1987.¹ The philosophy impartedhad much to do with attitudes to screening for HIV infection andits legacy on the present worldpandemic.

These authors assumed a false positive rate of 0.005% for combined Western blot testing and enzyme linked immunosorbent assay(ELISA) and a seroprevalence rate in the general population of0.01% (this represented the incidence of HIV infection in femaleblood donors in the United States in 1986). Thus testing a populationof 100 000 people would detect 10 genuine cases of HIV infectionand yield five false positive results. These odds were consideredto be an argument against screening. The fact that female blooddonors were not truly representative of the general populationand that random false positivity in testing could be appreciablyreduced by repeat testing wentunnoticed.

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Relevant Article

Methods in health service research: An introduction to bayesian methods in health technology assessment: David J Spiegelhalter, Jonathan P Myles, David R Jones, and Keith R Abrams
BMJ 1999 319: 508-512. [Extract] [Full Text] [PDF]

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