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May 1983

The Predictive Power of Diagnostic Tests and the Effect of Prevalence of Illness

Author Affiliations

From the Mailman Research Center (Drs Baldessarini, Finklestein, and Arana) and the Departments of Psychiatry (Drs Baldessarini and Arana) and Neurology (Dr Finklestein), McLean Hospital, Belmont, Mass; and Harvard Medical School (Drs Baldessarini, Finklestein, and Arana) and Massachusetts General Hospital (Drs Baldessarini and Finklestein), Boston.

Arch Gen Psychiatry. 1983;40(5):569-573. doi:10.1001/archpsyc.1983.01790050095011

• There is a great interest in the potential usefulness of biomedical tests in psychiatry, but basic statistical principles required for critical evaluation of their value remain poorly integrated into clinical thinking. We developed a useful scheme for organizing clinical test data so as to permit simple calculations of the sensitivity, specificity, and predictive power of medical tests. Some loss of predictive power is inherent in moving from artificial populations used for test development into more typical clinical settings, where prevalence is usually substantially lower.