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The appropriate use of diagnostics is important as misdiagnosis may have serious consequences. Confidence in a diagnostic test result depends on the test's accuracy (sensitivity and specificity) in the context of the use-case (who is tested and why) and the prevalence of the condition investigated. Here, we offer an approach to diagnostics focused on the risks and effects of making the wrong diagnosis. We propose 'fitness brackets' for a given test to define the range within which the test is fit-for-purpose, based on the use-case and risk-management principles. We use as exemplars tests for dengue pre-vaccination screening and tests for diagnosing Covid-19 in different settings.

Original publication

DOI

10.1016/j.ijid.2021.04.004

Type

Journal article

Journal

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

Publication Date

05/2021

Volume

106

Pages

382 - 385

Addresses

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK. Electronic address: piero.olliaro@ndm.ox.ac.uk.

Keywords

Humans, Diagnostic Errors, Mass Screening, Sensitivity and Specificity, COVID-19