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July 5, 2000

Human Papillomavirus Detection to Screen for Cervical Cancer—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;284(1):39-40. doi:10.1001/jama.284.1.39

In Reply: Dr Moselhi correctly points out the possibility of verification bias in our study, since only women with positive screening results were referred for the criterion standard of colposcopy. Schatzkin et al1 have described parameters that allow the performances of 2 screening tests to be compared even when the reference procedure cannot be performed on all samples. These include the ratio of sensitivities between the 2 tests, the ratio of false positivity of the 2 tests, and the positive predictive value of the tests. In our article, we compared the sensitivity and specificity of the screening tests by calculating the ratios of sensitivity and of false positivity of the HPV DNA test results to cytology and tested whether there were differences using the McNemar test.2

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