Bautsch Wilfried
Institut für Mikrobiologie, Immunologie und Krankenhaushygiene, Städtisches Klinikum Braunschweig gGmbH, Braunschweig, Germany.
Dtsch Arztebl Int. 2009 Jun;106(24):403-6. doi: 10.3238/arztebl.2009.0403. Epub 2009 Jun 12.
Current laboratory tests exhibit high sensitivity and specificity combined with comparatively low costs thus favoring broad and uncritical ordering habits.
Introduction of Bayes' theorem and discussion of its implications for laboratory test results in a mostly non-technical form, accompanied by a selective literature review.
According to Bayes' theorem the positive predictive value of laboratory test results is directly dependent on the prevalence of the disease in a given patient cohort. Thus, the clinical value of a given test result is critically dependent on a precise indication. Ordering of tests that are not indicated in a given patient is clinically useless and undesirable, where detailed information on disease prevalence is missing. These considerations are valid irrespective of ethical or economic considerations.
当前的实验室检测具有高灵敏度和特异性，且成本相对较低，因此助长了广泛且不加批判的检测申请习惯。
以一种大多为非技术性的形式引入贝叶斯定理，并讨论其对实验室检测结果的影响，同时进行选择性文献综述。
根据贝叶斯定理，实验室检测结果的阳性预测值直接取决于特定患者群体中疾病的患病率。因此，给定检测结果的临床价值严重依赖于精确的检测指征。在特定患者中申请未被指征的检测在临床上是无用且不可取的，因为缺少关于疾病患病率的详细信息。无论从伦理还是经济角度考虑，这些考量都是有效的。
