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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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Issues63Founded3 years agoLast Issue5 days ago
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Latest Issues

How should we communicate test accuracy to patients?

When I want to know what the evidence says about a medical question, the first place I usually look is the Cochrane Library. Cochrane reviews bring together all the relevant studies they can identify, assess their quality and use transparen...

5 days ago
11
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Leaf plots meet decision thresholds

A few years ago, I came across a paper introducing something called a leaf plot. It struck me as one of those ideas that makes you wonder why everyone isn’t using it. Leaf plots, introduced by Malcolm and Tom Coulthard, provide a remarkably...

13 days ago
2

How I Would Have Presented the Pluslife TB Paper

I recently wrote about the missing evaluation in an NEJM paper evaluating the Pluslife MiniDock MTB test for tuberculosis. As a follow-up, I’d like to re-present the paper in the way I would have liked to see it in the first place. The back...

a month ago
5
2

Meeting the Target, Missing the Point

Bad comedians often start their act with the question, ”Do you know what drives me crazy?”

As The Diagnostic Detective, there is one thing that genuinely drives me crazy: incomplete reporting of diagnostic accuracy studies, particularly wh...

2 months ago
15
11

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...

2 months ago
8
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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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