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検査がすべて正しいとは限らないことについて
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HiroyukiMatsuzaki
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検査がすべて正しいとは限らないことについて
1.
検査がすべて正しいとは 限らないことについて
2.
健康な人 病気の人
3.
100人のうち10人が病気の人です
4.
この全員にある検査をしたら どうなるでしょうか…?
5.
陽性…? 陰性…?
6.
当然、そうじゃないの?
7.
えっ、違うの…!?
8.
違うんです 検査は正しいとは限らないのです ある検査の場合、実際はこうなります
9.
「陽性」 「陰性」
10.
だいぶイメージと違う… ですよね。説明しましょう!
11.
この検査では、10人の病気の人 のうち、「陽性」と出るのは 実は4人だけなのです (これを、「検査の感度が40%」といいます)
12.
残りの6人は、本当は病気なのに 見逃されてしまうわけです (→この6人のことを、「ニセモノの陰性」なので 「偽陰性」といいます)
13.
俺たちは陰性だから 病気じゃないんだ!
14.
15.
一方、10人の健康な人のうち ちゃんと「陰性」と出るのは 9人です (これを、「検査の特異度が90%」といいます)
16.
この1人は、本当は健康なのに 「陽性」と出てしまうのですね (→「ニセモノの陽性」なので、「偽陽性」です)
17.
入院だ! 「陽性」だったんですって… まあ怖い… 仕事は…? お金が… 家族にうつる…? 猫の世話も… 俺死んじゃうの…? (※本当は「偽陽性」)
18.
例では、90人の健康な人のうち81人(90%) が正しく陰性と出ていたということです
19.
まとめると、この例は 「100人中10人が病気の集団」に 「感度40%、特異度90%の検査」 を行った場合ということでした。
20.
「病気の人の半分以上が見逃されている」 「“陽性”でも本当に病気とは限らない」
21.
この例はあくまでも架空のもので すが、「検査をすれば全て正しく 白黒つく」という考えは、必ずし も正しくない場合もあるんだよ、 ということが伝われば幸いです
22.
「陰性」だから安心できますか? 気兼ねなく外出していいですか? 「陽性」でも病気とも限りません それじゃあ、検査のメリットは何 でしょうか?(難しい問題です。ちなみにインフルエ ンザ検査も似たようなものです(特異度は例の場合より高いですが …))
23.
いずれにせよ確実なのは、このよ うな悩ましい状況は、「片っ端か ら検査をすればするほど」さらに 起こりやすくなってしまうという ことです…
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