Journal of clinical epidemiology
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Review
Diagnostic test accuracy may vary with prevalence: implications for evidence-based diagnosis.
Several studies and systematic reviews have reported results that indicate that sensitivity and specificity may vary with prevalence. ⋯ Sensitivity and specificity may vary in different clinical populations, and prevalence is a marker for such differences. Clinicians are advised to base their decisions on studies that most closely match their own clinical situation, using prevalence to guide the detection of differences in study population or study design.
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Randomized trials generally use "frequentist" statistics based on P-values and 95% confidence intervals. Frequentist methods have limitations that might be overcome, in part, by Bayesian inference. To illustrate these advantages, we re-analyzed randomized trials published in four general medical journals during 2004. ⋯ Bayesian and frequentist analyses complement each other when interpreting the results of randomized trials. Future reports of randomized trials should include both.