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In addition, “false positive” test results (i.e., a false indica-
tion of infection) occur in 0.4 percent of people who are
not infected. Hence, positive test results do not prove that
the person is infected. Nevertheless, infection seems more
likely for those who test positive, and Bayes’s theorem
provides a formula for evaluating the probability.
The logic of this formula is explained as follows:
Suppose that there are 10,000 intravenous drug users in
the population, of which 2,500 are infected with HIV.
Suppose further that if all 2,500 people are tested, 95
percent (2,375 people) will produce a positive test result.
The other 5 percent are known as “false negatives.” In
addition, of the remaining 7,500 people who are not
infected, about 0.4 percent, or 30 people, will test positive
(“false positives”). Because there are 2,405 positive tests
in all, the probability that a person testing positive is
actually infected can be calculated as 2,375/2,405, or about
98.8 percent.
Applications of Bayes’s theorem used to be limited
mostly to such straightforward problems, even though
the original version was more complex. There are two key
difficulties in extending these sorts of calculations, how-
ever. First, the starting probabilities are rarely so easily
quantified. They are often highly subjective. To return to
the HIV screening previously described, a patient might
appear to be an intravenous drug user but might be unwill-
ing to admit it. Subjective judgment would then enter
into the probability that the person indeed fell into this
high-risk category. Hence, the initial probability of HIV
infection would in turn depend on subjective judgment.
Second, the evidence is not often so simple as a positive
or negative test result. If the evidence takes the form of a
numerical score, the sum used in the denominator of the
above calculation must be replaced by an integral. More