The discrepancy in discrepant analysis

Lancet. 1996 Aug 31;348(9027):592-3. doi: 10.1016/S0140-6736(96)05122-7.


Discrepant analysis is a widely used technique that attempts to provide estimates of sensitivity and specificity in the presence of an imperfect gold-standard. This technique has been applied by many researchers to estimate the sensitivity and specificity of DNA-amplification tests for Chlamydia trachomatis such as the plasmid-based ligase chain-reaction and polymerase chain-reaction tests. However, the sensitivity and specificity estimates obtained by discrepant analysis are upwardly biased, and this bias remains even when a perfect test is used to resolve the discrepant results. This technique should not be adopted for evaluating the performance of a diagnostic test.

Publication types

  • Review

MeSH terms

  • Cervix Uteri / microbiology
  • Chlamydia Infections / diagnosis*
  • Chlamydia trachomatis / isolation & purification
  • Female
  • Gene Amplification*
  • Humans
  • Reference Standards
  • Sensitivity and Specificity*