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PubMed1987

The theorem of Bayes as a clinical research tool.

The theorem of Bayes is a powerful research tool that has a multitude of clinical applications. Its use has been somewhat restricted because of the intrinsic complexity of Bayesian theory and the need for computer support. We explain herein the Theorem of Bayes in practical terms that specifically apply to clinical research.

Bayes Theorem↗
PubMed2000

A diagnostic algorithm for carpal tunnel syndrome based on Bayes's theorem.

OBJECTIVE: To construct a diagnostic algorithm based on Bayes's theorem and using simple clinical tests to allow accurate diagnosis without resort to nerve conduction studies. METHOD: A cohort of patients being referred with possible carpal tunnel syndrome had clinical and electrophysiological testing, from which the simple calculations for sensitivity, specificity and prevalence were made and subsequently used in the formula of Bayes's theorem. The algorithm was then tested prospectively in a further cohort of similarly referred patients. RESULTS: The algorithm proved to be reliable when tested prospectively, and was similar to nerve conduction studies in diagnostic accuracy. CONCLUSION: A simple algorithm of clinical tests can identify patients without resort to nerve conduction studies, facilitating early treatment.

Algorithms↗
PubMed1975

Heterozygote tests and genetic counseling in maple syrup urine disease: an application of Baye's theorem.

The discriminatory power of a quantitative heterozygote test for Maple Syrup Urine Disease (MSUD) which we have been using is analyzed on the presumption that a single rare mutant allele is involved in MSUD. Bayes theorem then predicts that only a small portion of persons from the general population with activities in the heterozygous range really are heterozygotes. In addition, overlap of heterozygous and normal homozygous activity distributions requires rather high activities in first-cousin matings of a patient's sib in order to obviate the necessity for prenatal diagnosis. Thus, the principle emerges that quantitative heterozygote tests for rare autosomal recessive diseases cannot fulfill the task they were designed for.

Bayes Theorem↗
PubMed1988

The use of Baye's theorem and other indices of agreement in evaluating the use of reagent strips in screening rural schoolchildren for Schistosoma haematobium in Zambia.

The diagnosis of Schistosoma haematobium disease on the basis of history and physical examination alone is often difficult. Tests have thus been developed to allow an early and more accurate diagnosis. However these tests have substantial imperfections and many different results obtained from these tests must be integrated into a diagnostic conclusion about the probability of disease in a given patient. Also the accuracy of these tests in detecting S. haematobium disease is critically dependent not only on its sensitivity and specificity but also on the prevalence or pretest likelihood of disease in the population under study. The diagnostic accuracy of haematuria, proteinuria and the combined criteria tests in detecting S. haematobium eggs in schoolchildren are evaluated by calculating the sensitivity and specificity and also by the use of 'Bayes' theorem of conditional probability. The graphic relation between the predictive value of a given test result and the pretest risk of disease in the test subjects was obtained for each of these tests. This method reveals that the prevalence of S. haematobium disease is an important determinant of the predictive value of any test result in the individual patient.

Adolescent↗
PubMed1999

Bayes' theorem-based assessment of VDRL syphilis screening miss rates.

BACKGROUND AND OBJECTIVES: Interlaboratory differences (and conflicting practices) in syphilis screening strategies (serial versus parallel test combinations) prompted us to determine an estimate of the diagnostic miss rate in the detection of (1) infected persons and (2) infected but untreated persons potentially affected by late active syphilis. GOAL: We set out to establish the most efficient syphilis screening strategy for two routine tests (VDRL and Treponema pallidum hemagglutination assay [TPHA]) with regard to our tested public health population (average VDRL+ TPHA+ and VDRL- TPHA+ reactor ages being 59.9 years and 50.5 years, respectively. STUDY DESIGN: Retrospective analysis covered the results of a routine parallel VDRL and TPHA testing on 24,863 persons done in four public health laboratories. Nosologic sensitivity of the VDRL test (18.32%) was determined using the TPHA test as reference. The percentage of VDRL nonreactors among infected persons (TPHA reactors) was considered as the VDRL false negative rate (81.68%). We estimated the proportion of persons infected but untreated with potential late active syphilis using our own Bayes theorem-based procedure. RESULTS: The Bayes theorem-based estimate showed a significantly higher value for persons at risk of active late syphilis than the number of suspected cases obtained using the classical approach (25.1% versus 18.32%, or 83 persons versus 61 of the 330 infected). CONCLUSION: In screening an older population, the VDRL test alone (or as the first of a series with TPHA as a confirmation test) may produce a diagnostic miss rate higher than the syphilis detection rate. Another miss in such a population is detected by the Bayes theorem-based method.

Adult↗
PubMed1998

Hearing discordant voices: some notes on using Bayes's theorem in interpretive inquiry.

The focus of these brief comments is to argue that Bayes's theorem may have conceptual and pedagogical applications for qualitative analysis. We suggest that the theorem is a salient alternative voice for the development of sensitizing concepts. It is also proposed that the theorem is a useful heuristic for raising deep-structure issues such as the nature of qualitative evidence and how such evidence becomes confirming for a given claim.

Bayes Theorem↗