Likelihood Ratios in Diagnostic Testing - Calculation

Calculation

Two versions of the likelihood ratio exist, one for positive and one for negative test results. Respectively, they are known as the likelihood ratio positive (LR+) and likelihood ratio negative (LR–).

The likelihood ratio positive is calculated as

which is equivalent to

or "the probability of a person who has the disease testing positive divided by the probability of a person who does not have the disease testing positive." Here "T+" or "T−" denote that the result of the test is positive or negative, respectively. Likewise, "D+" or "D−" denote that the disease is present or absent, respectively. So "true positives" are those that test positive (T+) and have the disease (D+), and "false positives" are those that test positive (T+) but do not have the disease (D−).

The likelihood ratio negative is calculated as

which is equivalent to

or "the probability of a person who has the disease testing negative divided by the probability of a person who does not have the disease testing negative."

The pretest odds of a particular diagnosis, multiplied by the likelihood ratio, determines the post-test odds. This calculation is based on Bayes' theorem. (Note that odds can be calculated from, and then converted to, probability.)

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