I thank Dr Salomon for his comments on our findings regarding the operating characteristics of the potassium hydroxide smear. I wholeheartedly agree that even "simple" laboratory tests that have been in place for many years need to be evaluated objectively. Dr Salomon's belief regarding the reliability of the potassium hydroxide smear is widely held, yet not substantiated by data presented by us or others.1 Indeed, this belief was the impetus for the study. His comment about the test performance being affected by the individual performing the test merits commentary. Training is a key element for anyone performing a diagnostic test (physician or otherwise). However, the clinical findings preceding a test are irrelevant for the actual assessment of the test's sensitivity and specificity as performed by a trained individual. In fact, unbiased assessments of a diagnostic test are essential for accurate determination of the test's clinical worth.2
Miller MA. The Sensitivity and Specificity of the Potassium Hydroxide Smear-Reply. Arch Dermatol. 1993;129(10):1342–1343. doi:10.1001/archderm.1993.01680310114025
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