False positive results in screening tests have potentially severe psychological, medical, and financial consequences for the recipient. However, there have been few efforts to quantify how the risk of a false positive accumulates over time. We seek to fill this gap by estimating the probability that an individual who adheres to the U.S. Preventive Services Task Force (USPSTF) screening guidelines will receive at least one false positive in a lifetime. To do so, we assembled a data set of 116 studies cited by the USPSTF that report the number of true positives, false negatives, true negatives, and false positives for the primary screening procedure for one of five cancers or six sexually transmitted diseases. We use these data to estimate the probability that an individual in one of 14 demographic subpopulations will receive at least one false positive for one of these eleven diseases in a lifetime. We specify a suitable statistical model to account for the hierarchical structure of the data, and we use the parametric bootstrap to quantify the uncertainty surrounding our estimates. The estimated probability of receiving at least one false positive in a lifetime is 85.5% ($\pm$0.9%) and 38.9% ($\pm$3.6%) for baseline groups of women and men, respectively. It is higher for subpopulations recommended to screen more frequently than the baseline, including more vulnerable groups such as pregnant women and men who have sex with men. Since screening technology is imperfect, false positives remain inevitable. The high lifetime risk of a false positive reveals the importance of educating patients about this phenomenon.
翻译:检查检测结果的虚假结果可能会给接受者带来严重的心理、医疗和财务后果。然而,几乎没有努力量化五种癌症或六种性传染疾病初级检查程序的真实阳性、假阴性和假正性的风险如何随时间推移而累积。我们试图通过估计一个坚持美国预防性服务工作队(USPSTF)筛查准则的人一生至少将获得一个假阳性的可能性来填补这一差距。为此,我们收集了美国预防性服务工作队(USPSTF)引用的116项研究的数据集,其中报告了真实阳性、假阴性、真实负性以及假阳性的数量。我们利用这些数据来估计14种人口组之一的个人一生至少将获得1个假正性病例的概率。我们指定了适当的统计模型来说明数据的等级结构,我们用参数来量化我们估算的不确定性。 估计一生至少收到1种假正性阳性病例的概率是85.5% ($pm9.%) 和38.9% 女性的不真实性周期重要性($p3.6%) 以及女性的精确性基底值分别显示女性的可靠程度,而男性的基底值分别为5 %。