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How to read a paper: Papers that report diagnostic or screening tests
A correspondent has pointed out an error of terminology in thispaper by Trisha
Greenhalgh
(30 August, pp 540-3). The valuedescribed as the negative likelihood ratio and expressed
in
theformula (1-sensitivity)/specificity is, in reality, not thenegative likelihood ratio
but
a value which is described bythe question, "How much more likely is a negative result
to
befound in a person with, as opposed to without, the condition?"The negative likelihood
ratio is described by the question,"How much more likely is a negative result to be found
in aperson without, as opposed to with, the condition?" and is expressedby the formula
specificity/ (1-sensitivity). In the examplegiven, a negative urine test for glucose
does
indeed reducethe window cleaner's baseline chances of diabetes to 0.78 ofthe pretest
likelihood, but the negative likelihood ratio ofthe test is the reciprocal of this valuethat
is,
1.28.