BMJ  2004;329:168-169 (17 July), doi:10.1136/bmj.329.7458.168

Education and debate

Statistics Notes

Diagnostic tests 4: likelihood ratios

Jonathan J Deeks, senior research biostatistician1, Douglas G Altman, professor of statistics in medicine2

1 Screening and Test Evaluation Program, School of Public Health, University of Sydney, NSW 2006, Australia, 2 Cancer Research UK/NHS Centre for Statistics in Medicine, Institute for Health Sciences, Oxford OX3 7LF

Correspondence to: Mr Deeks Jon.Deeks@cancer.org.uk

The first 150 words of the full text of this article appear below.

The properties of a diagnostic or screening test are often described using sensitivity and specificity or predictive values, as described in previous Notes.1 2 Likelihood ratios are alternative statistics for summarising diagnostic accuracy, which have several particularly powerful properties that make them more useful clinically than other statistics.3

Each test result has its own likelihood ratio, which summarises how many times more (or less) likely patients with the disease are to have that particular result than patients without the disease. More formally, it is the ratio of the probability of the specific test result in people who do have the disease to the probability in people who do not.

A likelihood ratio greater than 1 indicates that the test result is associated with the presence of the disease, whereas a likelihood ratio less than 1 indicates that the test result is associated with the absence of disease. The further likelihood ratios . . . [Full text of this article]


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