van der Weijden T, van den Akker M
Universiteit Maastricht, capaciteitsgroep Huisartsgeneeskunde, Postbus 616, 6200 MD Maastricht.
Ned Tijdschr Geneeskd. 2001 May 12;145(19):906-8.
The number of requests for diagnostic tests is rising. This leads to a higher chance of false test results. The false-negative proportion of a test is the proportion of negative test results among the diseased subjects. The false-positive proportion is the proportion of positive test results among the healthy subjects. The calculation of the false-positive proportion is often incorrect. For example, instead of 1 minus the specificity it is calculated as 1 minus the positive predictive value. This can lead to incorrect decision-making with respect to the application of the test. Physicians must apply diagnostic tests in such a way that the risk of false test results is minimal. The patient should be aware that a perfectly conclusive diagnostic test is rare in medical practice, and should more often be informed of the implications of false-positive and false-negative test results.
诊断测试的请求数量正在上升。这导致出现错误测试结果的可能性更高。一项测试的假阴性比例是患病受试者中阴性测试结果的比例。假阳性比例是健康受试者中阳性测试结果的比例。假阳性比例的计算常常是错误的。例如,它不是用1减去特异性来计算,而是用1减去阳性预测值来计算。这可能导致在测试应用方面做出错误的决策。医生必须以将错误测试结果的风险降至最低的方式应用诊断测试。患者应该意识到,在医学实践中,完全确定性的诊断测试很少见,并且应该更经常地被告知假阳性和假阴性测试结果的影响。