Interpretation of screening test results: Scenario does not reflect day to day practice

doi:10.1136/bmj.333.7564.397-a

BMJ 2006;333:397 (19 August), doi:10.1136/bmj.333.7564.397-a

Letter

Interpretation of screening test results

Scenario does not reflect day to day practice

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

EDITOR—Bramwell et al's article on the interpretationof screening results for Down's syndrome highlights the difficultiesthat even professionals can experience in interpreting datafrom screening programmes.¹ However, the scenario presentingsuch difficulty is not the one faced by professionals and patientson a daily basis when informing patients of their screeningresults for Down's syndrome. Rather, it is how likely a positivetest from a screened population is in predicting a Down's syndromepregnancy.

For women who are screened for Down's syndrome, their uniqueresult will be presented either as, for example, "one in 100"or "1%," a much simpler scenario to convey even by statisticallychallenged obstetricians. However, there is ample publishedevidence that all women are made anxious by their positive screeningtest,² no matter how they are told, and women's experiencesshow that medical staff are unclear about the implications ofscreening tests and . . . [Full text of this article]

Mike Divers, consultant obstetrician

Nobles Hospital, Braddan, Isle of Man IM4 4RJ mike.divers@gov.im

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