than the pretest probability. A high likelihood ratio indicates a good test for a population, and a likelihood ratio close to one indicates that a test may not be appropriate for a population. For a screening test, the population of interest might be the general population of an area. For diagnostic testing, the ordering clinician will have observed some symptom or other factor that raises the pretest probability relative to the general population. A likelihood ratio of greater than 1 for a test in a population indicates that a positive test result is evidence that a condition is present. If the likelihood ratio for a test in a population is not clearly better than one, the test will not provide good evidence: the post-test probability will not be meaningfully different from the pretest probability. Knowing or estimating the likelihood ratio for a test in a population allows a clinician to better interpret the result. Research suggests that physicians rarely make these calculations in practice, however, and when they do, they often make errors. A randomized controlled trial compared how well physicians interpreted diagnostic tests that were presented as either sensitivity and specificity, a likelihood ratio, or an inexact graphic of the likelihood ratio, found no difference between the three modes in interpretation of test results. Estimation table This table provide examples of how changes in the likelihood ratio affects post-test probability of disease. *These estimates are accurate to within 10% of the calculated answer for all pre-test probabilities between 10% and 90%. The average error is only 4%. For polar extremes of pre-test probability >90% and <10%, see section below. Estimation example Pre-test probability: For example, if about 2 out of every 5 patients with abdominal distension have ascites, then the pretest probability is 40%. Likelihood Ratio: An example "test" is that the physical exam finding of bulging flanks has a positive likelihood ratio of 2.0 for ascites. Estimated change in probability: Based on table above, a likelihood ratio of 2.0 corresponds to an approximately +15% increase in probability. Final (post-test) probability: Therefore, bulging flanks increases the probability of ascites from 40% to about 55% (i.e., 40% + 15% = 55%, which is within 2% of the exact probability of 57%). Calculation example A medical example is the likelihood that a given test result would be expected in a patient with a certain disorder compared to the likelihood that same