Spectrum bias in the evaluation of diagnostic tests: Lessons from the rapid dipstick test for urinary tract infection Academic Article uri icon


MeSH Major

  • Bias (Epidemiology)
  • Reagent Strips
  • Sensitivity and Specificity
  • Urinary Tract Infections


  • The leukocyte esterase and bacterial nitrite dipstick test for UTI is susceptible to spectrum bias, which may be responsible for differences in the test's sensitivity reported in previous studies. As a more general principle, diagnostic tests may have different sensitivities or specificities in different parts of the clinical spectrum of the disease they purport to identify or exclude, but studies evaluating such tests rarely report sensitivity and specificity in subgroups defined by clinical symptoms. When diagnostic tests are evaluated, information about symptoms in the patients recruited for study should be included, and analyses should be done within appropriate clinical subgroups so that clinicians may decide if reported sensitivities and specificities are applicable to their patients.

publication date

  • July 15, 1992



  • Academic Article



  • eng

PubMed ID

  • 1605428

Additional Document Info

start page

  • 135

end page

  • 40


  • 117


  • 2