Sometimes a highly accurate test can be completely useless

Before beginning, let me be clear what this article is not about.

Whether it's a parachute,a cigarette, a flu medication or an air filter, RCTs have a niche role in answering healthcare questions.

Would a world with or without statins for primary prevention be healthier?

The NICE-defined high-risk NEWS2 category (scores ≥7) identified patients in whom each additional hour to antibiotic administration was associated with increased mortality, including many without shoc...

Why a high AUROC does not necessarily mean a diagnostic model is useful

Tuberculosis (TB) remains one of the world’s most pressing public health challenges, with millions of new cases (10.7 million) and deaths (1.23 million) reported annually [1]. Despite advances in diag...

Once-daily, single-tablet regimens have transformed care for persons living with human immunodeficiency virus type 1 (HIV-1); however, challenges to adherence continue to limit effective treatment....

Hospitalised adults with advanced HIV disease in sub-Saharan Africa experience high mortality, with tuberculosis, often disseminated and undiagnosed, …

Proposing a more clinically useful way to present diagnostic-accuracy studies of tests that produce a score

Why sensitivity and specificity don’t answer the questions patients ask

Abstract. Current guidelines for the management of meticillin-susceptible Staphyloccocus aureus bloodstream infection/bacteraemia (SAB) recommend intraveno

How a simple addition to an overlooked Bayesian graph can transform it into a clinical decision tool

Reframing a landmark TB diagnostic study through Bayes' theorem and clinical decision-making

Staphylococcus aureus bacteremia is associated with high mortality. Whether cefazolin or an antistaphylococcal penicillin should be preferred for the treatment of methicillin-susceptible S. aureus ...

It is often said that health is wealth and South Africa’s launch of the game

Why sensitivity and specificity don't tell clinicians what they need to know

In this proof-of-concept study, 4 months of DBQ showed a promising end-of-treatment non-inferiority signal versus 6 months of RHEZ and was generally well tolerated. Our results support further studies...

Better tests don’t necessarily improve outcomes. The problem isn’t the technology — it’s who we test, and when.

Part 1 of 2- they really do hardly ever show benefit

Treatment regimens containing integrase strand-transfer inhibitors (INSTIs) are taken lifelong by most people with HIV. The potency, tolerability, and high resistance barrier of INSTIs make them the t...

Sepsis is defined as a dysregulated host response to infection that leads to life-threatening organ dysfunction. The infectious insult triggers a dysregulated immune response that variably activates a...

The Diagnostic Detective revisits the NHS-Galleri trial, Bayesian belief, and the mathematics of disappointment

Randomized trials of long-acting injectable antiretroviral therapy (ART) in persons with human immunodeficiency virus (HIV) who face challenges with adherence to oral medication are lacking. We con...

Can Apple Smartwatches screen for hypertension?

Wearable tech a screening rather than diagnosis

The one about two Scotsmen, one disease, and two very different outcomes.

The one where microbiome science actually meets medicine, and where it still doesn’t

The one where trillions of microbes become celebrities

Exercise Is Great—So Why Doesn’t It Move the Scale like it Should?

Data Driven or a Test Looking for an Indication?

Mortality among adults hospitalized with advanced HIV disease (AHD; CD4 <200 cells μl−1 or a WHO stage 3 or 4 disease) is >20%; there is an urgent need to evaluate strategies to reduce mortality within this extremely high-risk group. Approximately ...

Who Really Needs the Sunshine Pill?

Two finger-stick blood tests to triage people with symptoms of pulmonary tuberculosis by measuring 3 host proteins (multibiomarker test) or 3 host RNA tran