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To be fair, being knowledgeable about the pre-test probability of a patient having a certain disease vs the sensitivity/specificity of a test IS part of the ideal practice of medicine, although how important it is in practice varies somewhat between specialities. In rheumatology for instance, it is front and center to how you make diagnoses. I was in primary care for a short while myself, and on more than one occasion regretted deeply ordering certain rheumatological screening panels (which you get without asking for it when looking for certain antibodies).

Explaining to a parent the fact that their child did in fact not have a rare, deadly and incurable multi-system disorder even though an antibody which is 98% specific for it showed up on the antibody assay, that we took for an entirely different reason, is the kind of thing thats hard to explain without understanding it yourself.



Bayesian thinking isn’t about p-values and doesn’t need to be presented that way.

If you use the centor criteria before resting for strep, is that worse than getting out a piece of paper and researching background population prevalence?

The OP is being dogmatic about doctors needing to know things he does which is obviously silly.

Edit - but yes, I agree that we should think about sensitivity and specificity, I just don’t think you need to be a statistician, just to have a helpful script and resources for patients who wish to know more.




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