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The Diagnostic Detective

The Diagnostic Detective introduces the world of medical tests to people without formal medical training. From the basics, to evaluating the latest medical technology, to advice on talking to your doctor about a test

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PricingOnly free issuesPublishesWeekly
Issues59Founded3 years agoLast Issue21 days ago
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Latest Issues

When “Accurate” Isn’t Enough: The Problem with Sensitivity and Specificity

A new TB test is published in The New England Journal of Medicine with sensitivity 86% and specificity 98% that meet WHO targets for diagnosis. It sounds excellent but if you’re a clinician, you still don’t know what to do. Sensitivity and...

21 days ago
8
4

Why Randomised Trials of Diagnostic Tests (almost) never show benefit to patients - Part 2

In Part 1, I argued that randomised controlled trials of diagnostic tests rarely show benefit in terms of patient relevant outcomes, living longer, happier lives. In Part 2 I want to provide a measure of explanation for why it isn’t necessa...

a month ago
5
6

Why Do Randomised Trials of Diagnostic Tests (Almost) Never Show Benefit to Patients?

We are very good at inventing better diagnostic tests. Faster, more sensitive, more sophisticated tests that promise earlier detection, greater accuracy, and better outcomes. Most tests are judged on their sensitivity and specificity, which...

a month ago
14
1

The Seductive Prior

Before the blood was drawn, before the randomisation, before the results, there was a story. A single blood test for dozens of cancers that could be detected early and save lives. It was a story so intuitively satisfying that it felt like d...

3 months ago
8
3

Why Screening Programmes (almost) Never Work: A Diagnostic Detective Story

Every good detective story begins with a puzzle that seems obvious at first glance. The victim is lying on the floor, the room is locked, and there are only a few suspects. Surely the answer cannot be far away. Screening programmes have alw...

4 months ago
17

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  • The Diagnostic Detective

    Tom Boyles is an Infectious diseases clinician, author of the book 'How to Request a Test'. He is fascinated by the science (and anti-science) of medical tests

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