Letters Implications of universal screening for HIV infection

Positive predictive value is poor in low risk populations seen in universal screening for HIV infection

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3575 (Published 04 June 2013) Cite this as: BMJ 2013;346:f3575
  1. James R Greig, medical microbiologist1,
  2. Deborah Batchelor,
  3. Mark Wallis
  1. 1Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth PL3 5TN, UK
  1. jamesgreig{at}nhs.net

Sugarman does not mention an inherent problem with screening for disease in low risk populations1—the poor positive predictive value (PPV) of even the most specific tests. The PPV conveys the likelihood that a positive test result is correct. It is related to test specificity but can be highly dependant on disease prevalence. Suggested screening thresholds range from one case per 500 …

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