Simple presentation of test accuracy may lead to inflated disease probabilities

doi:10.1136/bmj.326.7385.393/a

BMJ 2003;326:393 ( 15 February )

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Simple presentation of test accuracy may lead to inflated disease probabilities

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EDITOR $---$ We found that conveying information on the accuracy of tests in non-technical language improved doctors' ability toestimate disease probabilities accurately.¹ We investigatedwhether doctors might misuse such non-technical presentation whenconsidering the probability of endometrial cancer in a patientwith positive results on transvaginal ultrasonography.

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We presented 263 general practitioners in Switzerland with a pre-test probability of 10%, information that the patient wasaged 65, and a positive transvaginal ultrasound result. Ninetytwo general practitioners (group 1) received no information onthe test's accuracy; 92 (group 2) were told that the sensitivityof the test was 80% and specificity 60%; and 79 (group 3) weretold that a positive result is obtained twice as frequently inwomen with endometrial cancer as in those without the disease,reflecting a likelihood ratio of 2. The last two statements arenumerically equivalent since the likelihood ratio equals sensitivity/(1-specificity).

The table shows that the degree of . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Use a simple spreadsheet for accuracy calculations: GH Hall
bmj.com, 15 Feb 2003 [Full text]
Improving statistical interpretation using natural frequency format: Amit Ghosh, et al.
bmj.com, 17 Feb 2003 [Full text]