Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Multi-channel laboratory testing and the unexpected abnormal result: a statistical myth corrected

W R Phillips, D J Thompson

    The New Zealand Medical Journal
    |December 23, 1981
    PubMed
    Summary

    Statistical predictions often overestimate abnormal test results in healthy individuals. Clinical judgment, not flawed probability formulas, should guide physicians when interpreting unexpected lab findings.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Measurement of the high-energy gamma-ray emission from the Moon with the Fermi Large Area Telescope.

    Physical review. D. (2016)·2020
    Same author

    Observation of inverse Compton emission from a long γ-ray burst.

    Nature·2019
    Same author

    Differential cannibalism and population dynamics in a host-parasitoid system.

    Oecologia·2017
    Same author

    Suppression of Emittance Growth Using a Shaped Cold Atom Electron and Ion Source.

    Physical review letters·2016
    Same author

    THE IMPACT OF CRISIS UPON THE BEHAVIOR OF NATIONS IN THE 1960's.

    Multivariate behavioral research·2016
    Same author

    Classification of neurological abnormalities in children with congenital melanocytic naevus syndrome identifies magnetic resonance imaging as the best predictor of clinical outcome.

    The British journal of dermatology·2015

    Area of Science:

    • Clinical Chemistry
    • Medical Statistics
    • Health Services Research

    Background:

    • Multi-channel automated analyzers frequently produce abnormal test results, impacting healthcare economics and practice.
    • Critics argue that many abnormal results are statistical artifacts, not true indicators of disease.
    • Existing probability formulas for predicting abnormal results in healthy individuals often rely on unmet assumptions.

    Purpose of the Study:

    • To evaluate the accuracy of a common statistical formula used to predict the occurrence of abnormal test results in healthy individuals undergoing multi-channel blood chemistry screening.
    • To compare predicted abnormal result rates with observed rates in real-world screening programs.

    Main Methods:

    • Analysis of data from three screening programs involving 769 patients.

    Related Experiment Videos

  • Comparison of predicted abnormal result percentages using the formula p = sn (where n is the number of tests and s is the probability of a single test being within normal limits) against observed percentages.
  • Statistical evaluation of discrepancies between predicted and observed abnormal results.

    • Main Results:

    • The formula p = sn consistently overestimated the percentage of individuals with at least one abnormal test result across different test battery sizes (8, 14, and 17 tests).
    • For an 8-test battery, 33.7% were predicted abnormal vs. 20.6% observed.
    • For a 17-test battery, 58% were predicted abnormal vs. 33.3% observed.

    Conclusions:

    • The standard statistical formula for predicting abnormal results in healthy individuals is unreliable and overestimates the true incidence.
    • Clinical judgment is paramount in interpreting abnormal laboratory findings, rather than relying on potentially misleading statistical predictions.
    • Re-evaluation of how abnormal test results are interpreted in clinical practice and policy is warranted.