{"id":136,"date":"2010-09-08T15:39:12","date_gmt":"2010-09-08T14:39:12","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/adc-archimedes\/?p=136"},"modified":"2010-09-13T21:49:26","modified_gmt":"2010-09-13T20:49:26","slug":"natural-frequencies-keeping-it-real","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/adc\/2010\/09\/08\/natural-frequencies-keeping-it-real\/","title":{"rendered":"Natural frequencies &#8220;keeping it real&#8221;"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" style=\"margin-left: 3px;margin-right: 3px\" title=\"Amethyst\" src=\"http:\/\/www.powerofthecrystals.com\/web_images\/amethyst_cluster2.jpg\" alt=\"\" width=\"90\" height=\"70\" \/>So, on hearing Matthew Thompson open up a mini-session with natural frequencies my mind turned to the healing power of crystals, and I become acutely concerned that the open-minds approach of the Teaching EBM Conference had gone too far.<\/p>\n<p>But this was quashed quickly by his description: <!--more-->&#8216;Natural frequencies&#8217; means &#8216;real numbers&#8217; &#8230; like 30 of 100 patients, not 30% or 0.3 &#8230; and this is easier for most people to deal with.<\/p>\n<p>He went on to show that a single box can crack the nut of turning diagnostic test information from meaningless prattle into something highly understandable:<\/p>\n<p style=\"text-align: center\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" title=\"Diagnostics as real numbers\" src=\"http:\/\/bob_phillips.allmail.net\/thompson-slide\" alt=\"\" width=\"544\" height=\"407\" \/><\/p>\n<p>Using this approach means you can loose the faff of nomgrams, converting into odds or pocket calculating and work out, really quickly, what a test result means.<\/p>\n<p>It works like this: take a problem where 30% of the walk-ins will have it. The test you run has 50% sensitivity and 90% specificity. Of 100 people, 30 have the condition.\u00a0 50% sensitivity means half of the diseased have a +ve test (= 15). 90% specificity means 9\/10th of the undiseased will have a -ve test &#8230; so one-tenth (=7) will be test +ve.<\/p>\n<p>The result &#8211; 70% of the positive tests (15\/22) really do have the condition.<\/p>\n<p>Re-run it with a test prevalence of 60% :<\/p>\n<p style=\"text-align: center\">60 &gt;&gt;&gt;&gt;&gt;\u00a0 30<br \/>\n\/\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0 \u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0 .<br \/>\n\/disease\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 .<br \/>\n100\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 .<br \/>\n\\not disease\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 .<br \/>\n\\\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0 \u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0 .<br \/>\n40 &gt;&gt;&gt;&gt;&gt;\u00a0\u00a0\u00a0 4<\/p>\n<p style=\"text-align: left\">Now 30\/34 ~ 90% of +ve test results are in folk who really have the disease.<\/p>\n<p style=\"text-align: left\">Try it yourself with a prevalence of only 10% and see what the positive test really means &#8230;<\/p>\n<p style=\"text-align: left\">\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>So, on hearing Matthew Thompson open up a mini-session with natural frequencies my mind turned to the healing power of crystals, and I become acutely concerned that the open-minds approach of the Teaching EBM Conference had gone too far. But this was quashed quickly by his description: [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/adc\/2010\/09\/08\/natural-frequencies-keeping-it-real\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[79,80,81,1063],"tags":[],"class_list":["post-136","post","type-post","status-publish","format-standard","hentry","category-archimedes","category-critical-appraisal-note","category-diagnostics","category-teaching"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/136","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/comments?post=136"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/136\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/media?parent=136"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/categories?post=136"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/tags?post=136"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}