The Bayesian problem that 95 out of 100 physicians get wrong

Estimate the probability of a breast cancer in a given patient, given that the patient receives a positive result on a cancer screening test.

Assume that there is a 1% prevalence rate (that 1% of the population has breast cancer), a hit rate (sensitivity) of 80%, and a false positive rate of 9.6%.

Please provide this answer as a percentage to the tenths digit, for instance, 1.1 for 1.1%, as opposed to entering 0.011.


The answer is 7.8.

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1 solution

Bayes theorem is P ( A B ) = P ( B A ) × P ( A ) P ( B ) = P ( B A ) × P ( A ) P ( B A ) × P ( A ) + P ( B n o t A ) × P ( n o t A ) P(A\mid B) = \frac{P(B \mid A) \times P(A)} {P(B) } = \frac{ P(B\mid A) \times P(A)} {P(B\mid A) \times P(A) + P(B\mid not A) \times P(not A)}

In this case, lets borrow James Eddy's own notation to state this as: P ( c a p o s ) = P ( p o s c a ) × P ( c a ) P ( p o s c a ) × P ( c a ) + P ( p o s b e n i g n ) × P ( b e n i g n ) P(ca\mid pos) = \frac{ P(pos \mid ca) \times P(ca)} {P(pos\mid ca) \times P(ca) + P(pos\mid benign) \times P(benign)}
Where: P ( c a p o s ) P(ca\mid pos) is the probability that the patient has cancer given a positive result on the test (the posterior possibility).
P ( p o s c a ) P(pos \mid ca) is the probability that if a positive result appears on the test, then patient has cancer.
P ( c a ) P(ca) is the probability that any patient has cancer (the prior probability).
P ( p o s b e n i g n ) P(pos\mid benign) is the probability that if a a positive result appears on the test, then patient does not have cancer, that any cancer is benign.
P ( b e n i g n ) P(benign) is the probability that any patient does not have cancer, that any tumors they have are benign (the prior probability of not having cancer).


Now we can plug in the given variables:
P ( c a p o s ) = P ( p o s c a ) × P ( c a ) P ( p o s c a ) × P ( c a ) + P ( p o s b e n i g n ) × P ( b e n i g n ) = ( 0.80 ) × ( 0.01 ) ( 0.80 × 0.01 ) + ( 0.096 × 0.99 ) P(ca\mid pos) = \frac{ P(pos \mid ca) \times P(ca)} {P(pos\mid ca) \times P(ca) + P(pos\mid benign) \times P(benign)} = \frac{(0.80) \times (0.01)} {(0.80 \times 0.01) + (0.096 \times 0.99)} = .078 = 7.8%

Which means, that even if a patient gets a positive result back on this particular test, in this particular scenario where 1% of the population has cancer, then they still only have a 7.8% cancer of actually having cancer.

In his informal study, 95 out of 100 physicians listed the probability as between 70% and 80%, similar to the prior probability, but one order of magnitude off.

This visualization may help:

Christopher Williams - 5 years ago

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It is important to recognise what the question is really asking. The question asked what is the probability that a person has cancer (blue circle) given that the test is positive (green circle). This would intuitively mean that it is asking for the ratio of the overlapped portion of the two circles (i.e., both having cancer and tested positive) over the entire green circle (i.e. total group that tested positive regardless of whether they have cancer or not).

Wei Gee Ng - 2 years, 8 months ago

the answer is correct, however would certainly be awesome if one can explain it, not just showing the formula and memorize it.

Hans Henry - 3 years, 9 months ago

I find the answer but completely failed to put it correctly 0.0776397515527950 -> 0.08 or 0.078 or 8 not easy for non native english to fully understand the last statement. they should allow multiple good answer for the same question.

Tedi Kakatsi - 2 years, 3 months ago

The question is framed incorrectly and no answer can be provided. P(pos|ca) + P(pos|benign) has to add to 1. If you test positive, you have the cancer or you don't.

David Grybowski - 1 year, 1 month ago

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