你的结论与第二条矛盾。prevalence = (TP+FN)/Total = 0.05, Total = TP+FN+TN+FP
sensitivity = P( test positive | infected) = TP/(TP+FN) = 0.94
specificity = P( test negative | not infected) = TN/(TN+FP) = 0.96
By Bayes' Theorem,
PPV = P(infected | test positive) = sensitivity * prevalence / ( sensitivity * prevalence + (1-specificity) * (1-prevalence))
= 0.94*0.05/(0.94*0.05+0.04*0.95) = 0.553
Caveat: Residents with suspected mild symptoms who requested for nucleic acid testing at any Community Testing Centers were tested at least twice. Hospitalized patients received much more nucleic acid testing + serological testing + examination of clinical & radiologic signs. The sensitivity for multiple tests combined (at least one positive) is higher than sensitivity of a single nucleic acid test, and the PPV of multiple tests combined is higher than PPV of a single test.
test positive test negative disease positive true positive (TP) false negative (FN) sensitivity = TP/(TP+FN) disease negative false positive (FP) true negative (TN) 1-specificity = FP/(FP+TN) PPV=TP/(TP+FP)
你的结论与第二条矛盾。
prevalence = (TP+FN)/Total = 0.05, Total = TP+FN+TN+FP
sensitivity = P( test positive | infected) = TP/(TP+FN) = 0.94
specificity = P( test negative | not infected) = TN/(TN+FP) = 0.96
By Bayes' Theorem,
PPV = P(infected | test positive) = sensitivity * prevalence / ( sensitivity * prevalence + (1-specificity) * (1-prevalence))
= 0.94*0.05/(0.94*0.05+0.04*0.95) = 0.553
Caveat: Residents with suspected mild symptoms who requested for nucleic acid testing at any Community Testing Centers were tested at least twice. Hospitalized patients received much more nucleic acid testing + serological testing + examination of clinical & radiologic signs. The sensitivity for multiple tests combined (at least one positive) is higher than sensitivity of a single nucleic acid test, and the PPV of multiple tests combined is higher than PPV of a single test.
test positive test negative disease positive true positive (TP) false negative (FN) sensitivity = TP/(TP+FN) disease negative false positive (FP) true negative (TN) 1-specificity = FP/(FP+TN) PPV=TP/(TP+FP)
1, 既然是题目,就应该有确定的答案,不能模棱两块可,似是而非。Caveat 是一个警示而不是结论。我的意思是,在多次检测的情况下,题目里设定的情景所要说明的 “PPV 并不是那么高” 这个结论可能并不成立。把多次检测的情况简化为社区检测中心的两次核酸检测 (实际上入院的检测包括了至少两次 nucleic acid testing + serological testing + examination of clinical & radiologic signs),sensitivity = P( at least one test positive | infected) 会比 sensitivity of a single test 高,如果简单地假定 specificity 不变的话,不难得出多次检测的 PPV=P(infected | at least one test positive) 比题目里计算出的 PPV of a single test 要高。但是 sensitivity 里并集 at least one test positive 对应的是 specificity 里的交集 both tests negative,specificity = P( both tests negative | not infected),因此并不能简单假定 specificity 不变;specificity = P( both tests negative | not infected) 实际上 <= specificity of a single test,因此依据我给出的 PPV 公式,PPV=P(infected | at least one test positive) is higher than PPV of a single test 仍然是成立的。不止核酸检测,临床表征、影像学检查也应该算作是 test,基于各种不同的诊断学检测和临床表征的 PPV 是可以做到比较高的。
In epidemiology, assuming there is no spectrum bias, sensitivity and specificity are independent of prevalence. PPV is a function of prevalence, sensitivity and specificity. PPV = P(infected | test positive) = sensitivity * prevalence / ( sensitivity * prevalence + (1-specificity) * (1-prevalence)).
以上的概率记号里竖线均表示条件概率。如果学习工作里从未接触条件概率,也不是 medicine, public health, epidemiology, biostatistics 专业的,就请不必过于劳心钻研了。