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Post-Test Probability Calculator

Free post-test probability calculator. Compute from pre-test and LR. Fagan nomogram, Bayes theorem,

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Why This Statistical Analysis Matters

Why: Statistical calculator for analysis.

How: Enter inputs and compute results.

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CLINICAL DECISION SUPPORTFagan nomogram

Post-Test Probability — From Pre-Test and LR to Clinical Action

Use sensitivity, specificity, and likelihood ratios with Bayes' theorem. Fagan nomogram visualization. Rule in, rule out, sequential testing.

Real-World Scenarios — Click to Load

posttest_results.sh
CALCULATED
$ posttest --pre=10% --mode="sens_spec"
Post-test probability (positive test)
50.00%
Post-test probability (negative test)
1.22%
LR+
9.00
Good
LR−
0.11
Good
Pre-test
10%
Post-test (+)
50.00%
Share:
Post-Test Probability
Pre-test 10% → Post-test (+) 50.0%
LR+ = 9.00
LR−: 0.11Post (−): 1.2%
numbervibe.com/calculators/statistics/post-test-probability-calculator

Fagan-Style Nomogram

Pre-test prob
10%
LR+
9.0
Post-test prob (+)
50.0%

Visual line: Pre-test → LR → Post-test (Fagan 1975)

Pre-test vs Post-test Probability

Probability Distribution (positive test)

Fagan Nomogram Flow

Calculation Breakdown

BAYES
Pre-test odds
0.1111
P/(1-P) = 0.1000/(1-0.1000)
LIKELIHOOD RATIOS
LR+
9.00
Sens/(1-Spec)
LR−
0.11
(1-Sens)/Spec
POST-TEST
Post-test odds (+)
1.0000
Pre × LR+ = 0.1111 × 9.00
Post-test prob (+)
50.00%
Odds/(1+Odds)
Post-test prob (−)
1.22%
ext{Same} ext{with} ext{LR}-

For educational and informational purposes only. Verify with a qualified professional.

Key Takeaways

  • Pre-test probability matters more than test accuracy for rare diseases — a "95% accurate" test can be wrong 90%+ of the time when prevalence is low
  • LR+ > 10 is "rule in" — strong evidence for disease; LR− < 0.1 is "rule out" — strong evidence against disease
  • Sequential testing shifts probability: each test result updates the prior for the next test
  • • The Fagan nomogram (1975) provides a visual line from pre-test probability through LR to post-test probability
  • • Post-test odds = Pre-test odds × LR. Convert odds to probability: P = odds / (1 + odds)

Did You Know?

📐Thomas J. Fagan invented the nomogram in 1975 — a simple visual tool to convert pre-test probability through LR to post-test probabilitySource: NEJM, 1975
🧠Most clinicians overestimate post-test probability — studies show systematic overestimation of 20–30% for positive testsSource: JAMA
📊LR is constant regardless of prevalence — the same test has the same LR+ and LR− in any populationSource: BMJ Statistics
🩺A &quot;95% accurate&quot; test for a 1-in-10,000 disease can be wrong 90%+ of the time — base rate dominatesSource: False Positive Paradox
🔬PPV and NPV depend on prevalence; LR+ and LR− do not — that is why LRs are preferred for test comparisonSource: Cochrane
⚖️Sequential testing: a negative D-dimer (LR− ≈ 0.1) can rule out DVT when pre-test probability is lowSource: Clinical guidelines

Expert Tips

Use sequential testing

For borderline results, a second test updates the prior — post-test from test 1 becomes pre-test for test 2.

Consider clinical context

Numbers alone do not replace clinical gestalt — combine with history, exam, and risk factors.

LR > 10 or < 0.1

These generate large probability shifts — useful for rule-in and rule-out decisions.

Validate pre-test probability

Pre-test probability is often estimated from experience — validate with published prevalence when available.

Common Diagnostic Tests

TestSensitivitySpecificityLR+LR−
Mammography87%93%12.40.14
Troponin (hs)95%90%9.50.06
COVID PCR98%99%980.02
D-dimer96%40%1.60.1
PSA80%70%2.70.29
Strep rapid86%95%17.20.15
CTPA95%97%31.70.05

Frequently Asked Questions

What is post-test probability?

The probability of disease after knowing the test result. For a positive test: P(disease|positive). For a negative test: P(disease|negative). It is computed from pre-test probability and likelihood ratios via Bayes' theorem.

What is the difference between PPV and post-test probability?

PPV is post-test probability after a positive test when pre-test probability equals prevalence. Post-test probability is more general — it can use any pre-test probability (e.g., from clinical assessment).

When does LR+ "rule in" disease?

LR+ > 10 is often considered strong evidence to rule in. LR+ 5–10 is moderate; 2–5 is fair; 1–2 is poor. The exact threshold depends on the clinical context.

When does LR− "rule out" disease?

LR− < 0.1 is strong evidence to rule out. LR− 0.1–0.2 is good; 0.2–0.5 is fair; 0.5–1 is poor. D-dimer for DVT is a classic rule-out test (LR− ≈ 0.1).

Why use likelihood ratios instead of sensitivity/specificity?

LRs combine sensitivity and specificity into a single number that directly multiplies odds. They are independent of prevalence, making them portable across populations.

What is the Fagan nomogram?

A visual tool (1975) with three vertical axes: pre-test probability, likelihood ratio, and post-test probability. Draw a straight line through your values to read the result.

How do I use sequential testing?

After test 1, the post-test probability becomes the pre-test probability for test 2. Enter the first post-test probability as the new pre-test probability and apply the second test's LR.

Why does a "95% accurate" test fail for rare diseases?

When prevalence is very low, the large number of healthy people generates many false positives. Even with 95% specificity, 5% of healthy people test positive — swamping the few true positives.

By the Numbers

1975
Fagan nomogram invented
LR+ > 10
Rule in threshold
LR− < 0.1
Rule out threshold
20–30%
Clinician overestimation

Medical Disclaimer: This calculator is for educational purposes only. It is not a substitute for clinical judgment, professional medical advice, or formal diagnostic protocols. Consult qualified healthcare providers for medical decisions.

WHY IT MATTERS
💡Statistical calculator for analysis.
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