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Trusting numbers: uncertainty and the pathology laboratory

T Paul Hutchinson
Med J Aust 2003; 178 (3): . || doi: 10.5694/j.1326-5377.2003.tb05114.x
Published online: 3 February 2003

To the Editor: White emphasised problems that can arise if medical decisions are overly reliant on the results of laboratory tests.1 He relates the case of a patient who, because of a peculiarity of her immunology, consistently produced a false-positive test result. In probabilistic language, the issue is are there risks of both random errors and patient-specific errors? It is important to distinguish between them. Suppose a test has a false-positive rate of 10%. If this is truly random error, the probability of two false-positive results in the same person is 1%, and the probability of three false-positive results is tiny. But if it is due to there being 10% of healthy people for whom the test is invalid and who consistently give a positive result, the probability of two false-positive results in the same person is 10%, and the probability of three false-positive results is 10%!




Correspondence: 

  • 1. White GH. Trusting numbers: uncertainty and the pathology laboratory. Med J Aust 2002; 177: 153-155. <eMJA full text>
  • 2. Lee TH. Interpretation of data for clinical decisions. In: Cecil textbook of medicine. 21st ed. Philadelphia: Saunders, 2000; 79-84.
  • 3. Goldman L. Quantitative aspects of clinical reasoning. In: Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill, 1998; 9-14.
  • 4. Mitrushina MN, Boone KB, D'Elia LF. Handbook of normative data for neuropsychological assessment. New York: Oxford University Press, 1999; 16.
  • 5. Young DS, Bermes EW. Specimen collection and processing: sources of biological variation. In: Tietz textbook of clinical chemistry. 3rd ed. Philadelphia: Saunders, 1999; 42-72.

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