RICHARD A. L. STURDEVANT, M.D.
To the editor: Failure to recognize that the usefulness of a diagnostic test in differential diagnosis is related to the prevalence of the diseases requiring differentiation may lead to erroneous conclusions. Even as sensitive and specific a test as the antimitochondrial antibody for primary biliary cirrhosis (1) requires evaluation for its usefulness in differential diagnosis from the point of view of relative prevalence of the diseases.
Consider the problem of separating primary biliary cirrhosis from extrahepatic bile duct obstruction, assuming for simplification that no other diagnosis is possible. Local experience suggests that the prevalence of this obstruction is approximately thirty times greater
STURDEVANT RAL. Antimitochondrial Antibody in Diagnosis of Liver Disease. Ann Intern Med. ;78:312–314. doi: 10.7326/0003-4819-78-2-313
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Published: Ann Intern Med. 1973;78(2):312-314.
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