Media attention can impede positive predictive value of clinical diagnosis of low prevalence disease

Smout and colleagues say that during periods of high prevalence of pertussis the positive predictive value of a clinical diagnosis is greater than when the prevalence is low.1 While this is a mathematical certainty, recent dialogue, medical publications, and media attention can considerably decrease the positive predictive value of the clinical diagnosis of low prevalence disease.Extensive education about disease that is distributed in the media leads to availability bias in clinicians.2 This was particularly notable during the outbreak of invasive group A streptococcal infections at the end of 2022.3 Absolute prevalence of whooping cough remains low, especially when compared with other causes of respiratory tract symptoms. The benefit of prompt treatment and infection prevention must be compared with the potential harm of investigation, anxiety, and the population level cost of using microbiological resources after a clinical diagnosis.Care must be taken to balance education and awareness of outbreaks of low prevalence…
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