On uncertainty in medical testing.

Journal Article (Journal Article)

There is confusion in the medical decision-making literature about how to handle uncertainty in medical tests. In this article, the authors consider the situation in which there is uncertainty about the pretest probability of a disease in a patient as well as uncertainty about the sensitivity and specificity of a diagnostic test for that disease. They discuss how to calculate posttest probabilities of a disease under such uncertainty and how to calculate a distribution for a posttest probability. They show that given certain independence assumptions, uncertainty about these parameters need not complicate the calculation of patient positive predictive values: One can simply use the expected values of the parameters in the standard Bayesian formula for posttest probabilities. The discussion on how to calculate distributions for positive predictive values corrects a common and potentially important error.

Full Text

Duke Authors

Cited Authors

  • Winkler, RL; Smith, JE

Published Date

  • November 2004

Published In

Volume / Issue

  • 24 / 6

Start / End Page

  • 654 - 658

PubMed ID

  • 15534345

Electronic International Standard Serial Number (EISSN)

  • 1552-681X

International Standard Serial Number (ISSN)

  • 0272-989X

Digital Object Identifier (DOI)

  • 10.1177/0272989x04271045


  • eng