Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 1:2:2.
doi: 10.1186/s41512-017-0023-0. eCollection 2018.

Understanding test accuracy research: a test consequence graphic

Penny Whiting  1   2 , Clare Davenport  3
Affiliations

Understanding test accuracy research: a test consequence graphic

Penny Whiting et al. Diagn Progn Res. .

Abstract

Background: Presenting results of diagnostic test accuracy research so that it is accessible to users is challenging. Commonly used accuracy measures (e.g. sensitivity and specificity) are poorly understood by health professionals and the public. Evidence suggests that presenting probabilities as natural frequencies rather than percentages facilitates understanding. We present a test consequence graphic to display results based on natural frequencies and test consequences.

Methods: The graphic was developed as part of a project to develop guidance for writing plain language summaries for Cochrane diagnostic test accuracy (DTA) reviews. Using a mixed methods approach (focus groups, user testing, web-based surveys, public engagement and piloting), the graphic emerged as a clear preference out of a range of methods for presenting probabilistic information (text only, numbers embedded in text, annotated graphic) across patient representatives, media representatives and health professionals. The structure of the graphic was refined during the research process.

Results: The test consequence graphic displays the results of diagnostic test accuracy study or review as natural frequencies based on a hypothetical cohort of 1000 patients receiving the test.

Conclusions: The test consequence graphic provides a tool to help researchers communicate the results of diagnostic research in a simple, easy to access format and encourage meaningful application of research findings to practice. Key to this is linking estimates of test accuracy to potential downstream consequences of testing.

Keywords: Diagnosis; Graphical display; Natural frequencies.

PubMed Disclaimer

Conflict of interest statement

Not applicableNot applicableThe authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Template for development of example figure
Fig. 2
Fig. 2
Figure showing results that would be obtained if a hypothetical cohort of 1000 children were tested for strep A infection using rapid tests
See this image and copyright information in PMC

References

    1. Whiting PF, Davenport C, Jameson C, et al. How well do health professionals interpret diagnostic information? A systematic review. BMJ Open. 2015;5(7):e008155. doi: 10.1136/bmjopen-2015-008155. - DOI - PMC - PubMed
    1. Gigerenzer G. What are natural frequencies? BMJ. 2011;343:d6386. doi: 10.1136/bmj.d6386. - DOI - PubMed
    1. Julian-Reynier C, Welkenhuysen M, Hagoel L, et al. Risk communication strategies: state of the art and effectiveness in the context of cancer genetic services. Eur J Hum Genet. 2003;11(10):725–736. doi: 10.1038/sj.ejhg.5201037. - DOI - PubMed
    1. Lipkus IM, Crawford Y, Fenn K, et al. Testing different formats for communicating colorectal cancer risk. J Health Commun. 1999;4(4):311–324. doi: 10.1080/108107399126841. - DOI - PubMed
    1. Siegrist M, Orlow P, Keller C. The effect of graphical and numerical presentation of hypothetical prenatal diagnosis results on risk perception. Med Decis Making. 2008;28(4):567–574. doi: 10.1177/0272989X08315237. - DOI - PubMed

LinkOut - more resources