Intended for healthcare professionals

Letters New diagnostic tests: more harm than good

Sensitivity and specificity are not appropriate for diagnostic reasoning

BMJ 2017; 358 doi: (Published 06 September 2017) Cite this as: BMJ 2017;358:j4071
  1. Huw Llewelyn, consultant physician and honorary departmental fellow in mathematics
  1. Aberystwyth University, Penglais, Aberystwyth SY23 3FL, UK
  1. hul2{at}

Hofmann and Welch discuss the dangers of diagnostic tests.1 The problem is that tests are currently assessed using only sensitivity and specificity, which were developed during the second world war for radar detection. The STARD and GRADE guidelines recommend only these indices of performance for screening tests; they are …

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