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August 10, 1994

Potential Cost of Screening Surgeons for HIV-Reply

Author Affiliations

University of California—San Francisco
University of California—Berkeley

JAMA. 1994;272(6):434-435. doi:10.1001/jama.1994.03520060032022

In Reply.  —We thank Drs Roizen, Foss, and Mantha for reemphasizing the potential impact of false-positive test results that may occur when testing a low-prevalence population such as physicians and dentists. As they noted, with our baseline estimate as 0.4% prevalence, 20% of physicians testing positive would be false positives.As Roizen et al discuss, the costs of false-positive test results will depend on the prevalence in the population, the sensitivity and specificity of the testing sequence, and the consequences of false results. We stated in our article that the true values for these factors are uncertain; therefore, we used a wide range of values in our sensitivity analyses. Our analysis could not quantify all the potential costs and benefits of testing programs, some of which are nicely described by Roizen et al. Our analysis does include the costs of physician visits and of monitoring CD4+ counts in individuals with

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