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At least for some tests this MIGHT not be so hard... For example 1) our state dept of health circulates weekly prevalence date for influenza, based on selected testing, which are then used to give estimates of PPV and NPV for rapid influenza testing 2) for cardiac stress testing, the work of Diamond, et al (J Am Coll Cardiol1983;1:574–575. ) gives pretest estimates of CAD based on chest pain characteristics. The big assumption, as always is that one's patient somehow resembles the derivation population. While it would not be all-inclusive, if someone (with the time to do it!) were to at least put together in one place the PPV/NPVs of certain COMMON tests. Second thought - I like the idea of references to back up the 10 commandments - would make them even better as a teaching tool! BC Bill Cayley, Jr, MD MDiv [log in to unmask] [log in to unmask] Work: Augusta Family Medicine 207 W Lincoln, Augusta, WI 54722 Tel: 715.286.2270 Pager: 715.838.7940 Home: 3604 Sharon Drive, Eau Claire, WI 54701 Tel: 715.830.0932 Mobile: 715.828.4636 Mälkam gäna! (Happy Ethiopian Christmas!) http://www.ehow.com/how_10775_celebrate-ethiopian-christmas.html ________________________________ From: Michael Power <[log in to unmask]> To: [log in to unmask] Sent: Sunday, January 8, 2012 7:59 AM Subject: Re: Ten commandments for testing Rakesh We’d be in 7th heaven if we could get a such list – it is much harder to build than it seems From:Rakesh Biswas [mailto:[log in to unmask]] Sent: 08 January 2012 10:05 To: Michael Power Cc: [log in to unmask] Subject: Re: Ten commandments for testing It may also require a complementary list of reference best estimates of PPVs and NPVs for each Lab test ( for that particular population) to go with it? Some physicians may demand seeing this complementary list to make sure most of their local test predictive values are perhaps over 50%?. Circulating these commandments will generate a reawakening and re-engagement of most physicians toward their labs (they may wonder why any test with less than 50% predictive value would be allowed to run at all)? :-) On Sun, Jan 8, 2012 at 3:19 PM, Michael Power <[log in to unmask]> wrote: I have the same reservations Bill – I will work on it, but it is quite a challenge – the problem is that the core concept of each commandment needs explanation — unlike “thou shalt not kill”, “thou shalt practice evidence-based testing” needs at least a mention of prevalence, PPV, and NPV. It also needs, I think, a reference to a good starting point for more information. From:Bill Cayley, Jr [mailto:[log in to unmask]] Sent: 08 January 2012 03:54 To: Michael Power; [log in to unmask] Subject: Re: Ten commandments for testing Michael I really like these, but I wonder if there is a way to tighten up each "commandment" - These could be useful as a way to organize teaching points, but the way they are written now each point is almost a mini lecture itself. Can the points be tightned up so each one is concise and pithy - and perhaps one sentence? Thanks! Bill Cayley, Jr, MD MDiv [log in to unmask] [log in to unmask] Work: Augusta Family Medicine 207 W Lincoln, Augusta, WI 54722 Tel: 715.286.2270 Pager: 715.838.7940 Home: 3604 Sharon Drive, Eau Claire, WI 54701 Tel: 715.830.0932 Mobile: 715.828.4636 Mälkam gäna! (Happy Ethiopian Christmas!) http://www.ehow.com/how_10775_celebrate-ethiopian-christmas.html