To the Editor.—
Bates and Mulinare (214:2173,1970) put an undeserved onus on the physician for being reluctant to use screening tests. Someplace in their article the authors might have pointed out that the physicians' intuitive reluctance was worthwhile. Since the screening tests have only 95% confidence limits,1 in a panel of 20 tests there is a 60% chance than one will be spuriously abnormal in a normal patient.Unfortunately, performing more and more tests will not discover more and more unsuspected diseases.Hence, when there is a clinical indication for the test, its interpretation is more likely to be accurate. We should all be wary of the latest nondisease, idiopathic screenopathy.
Shapiro E. Screening Tests in Ambulatory Practice. JAMA. 1971;215(8):1328. doi:10.1001/jama.1971.03180210072028