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Tools for Decision Making Sections
Author Bio
Introduction
Probability Theory
Case Study 1: Patient History
Bayes' Theorem
Methods for Estimating Pre-test Probability
Estimating Likelihood Ratios
Sensitivity and Specificity
Interpreting Test Results
Currently selected section: Calculating Post-test Probabilities
Post-test Probabilities in Clinical Practice
Conclusions: Case Study 1
Part II
Part III
References


Chapter 14: Tools for Decision Making: Calculating Post-test Probabilities
        

To determine which of two tests -- dobutamine echo or exercise ECG -- is preferable, you must first calculate the post-test probability of disease for each test.

In this case, the pre-test probability of coronary artery disease is 0.25, which corresponds to pre-test odds of 1:3. Now, recall Bayes' theorem:

Post-test odds = pre-test odds x likelihood ratio

Click for how to convert odds to probability

Click for how to convert probability to odds

Analyze the table of post-test probabilities below.

Table 1.9.1: Post-test Probabilities
Dobutamine echocardiogram Exercise ECG
pre-test odds 1 in 3 1 in 3
post-test odds
test positive
1.5 to 1 1 to 1
test negative 1 in 20 1 in 7
post-test p[CAD]
test positive 0.60 0.50
test negative 0.04 0.12

Question 1.9.1

Which test is preferable and why?

Selection ADobutamine echocardiogram is the better test.
Selection BThe exercise ECG is the better test.
Selection CThe two tests are equally useful.
Selection DNeither test is useful.




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