September 5, 2023

The Value of Standardized Predictive Values in Diagnostic Testing

This letter to the editor published in the Journal of Magnetic Resonance Imaging discusses the usefulness of standardizing the predictive value of diagnostic tests. The author, Dr. Thomas F. Heston, argues that presenting predictive values standardized to a disease prevalence of 50% is more clinically useful than using the Predictive Summary Index. He explains that the Predictive Summary Index averages predictive values across a population, but does not account for the wide variability in disease prevalence between individual patients. In contrast, standardizing to a 50% prevalence reflects the common clinical scenario where the pre-test probability is intermediate and additional testing is warranted. While population-based metrics are useful for policy, Dr. Heston contends that individual predictive values are more practical for clinicians applying research to patient care.

Citation: Heston TF. The value of standardized predictive values in diagnostic testing. J Magn Reson Imaging. 2014;39(5):1338. doi: https://doi.org/10.1002/jmri.24564