Post-test Probability Calculator

Post-Test Probability Calculator

Calculate post-test probability using Bayes' theorem—essential for medical diagnosis and risk assessment.

Last updated: March 2026

Test Parameters

True positive rate

True negative rate

Post-Test Probability
48.65%
Probability of disease given positive test
Pre-test Probability5.00%
Likelihood Ratio Used18.0000
LR+ (Positive)18.0000
LR− (Negative)0.1053
Pre-test Odds0.0526
Post-test Odds0.9474

What is Post-Test Probability?

Post-test probability is the probability that a patient has a disease after receiving a test result. It updates the pre-test probability (prevalence or clinical suspicion) based on the test's performance characteristics (sensitivity and specificity) using Bayes' theorem.

This calculation is fundamental in medical decision-making. A positive test doesn't guarantee disease, and a negative test doesn't guarantee absence of disease. The post-test probability quantifies the actual risk, accounting for both the test's accuracy and how common the condition is in the population.

The calculation uses likelihood ratios, which indicate how much a test result changes the odds of disease. LR+ shows how much a positive test increases disease probability, while LR− shows how much a negative test decreases it. Tests with LR+ > 10 or LR− < 0.1 are considered highly informative.

How to Calculate Post-Test Probability

The Formula (Using Likelihood Ratios)

LR+ = Sensitivity / (1 − Specificity)
LR− = (1 − Sensitivity) / Specificity
Post-test odds = Pre-test odds × LR
Post-test probability = Post-test odds / (1 + Post-test odds)
Pre-test odds = Prevalence / (1 − Prevalence)
Use LR+ for positive test, LR− for negative test

Step-by-Step Process

Step 1: Determine pre-test probability (prevalence or clinical suspicion)
Step 2: Calculate LR+ and LR− from sensitivity and specificity
Step 3: Convert pre-test probability to odds
Step 4: Multiply pre-test odds by appropriate LR (+ or −)
Step 5: Convert post-test odds back to probability
Step 6: Interpret result in clinical context

Key Concepts

Sensitivity: Probability test is positive when disease is present (true positive rate)
Specificity: Probability test is negative when disease is absent (true negative rate)
Likelihood Ratio: How much the test result changes disease probability
Odds: Probability / (1 − Probability), another way to express chance

Example: COVID-19 Test

A patient tests positive for COVID-19:

Given:
Pre-test probability (prevalence): 5%
Sensitivity: 90%
Specificity: 95%
Test result: Positive
Step 1:
Calculate LR+:
LR+ = 0.90 / (1 − 0.95) = 0.90 / 0.05 = 18.0
Step 2:
Convert pre-test probability to odds:
Pre-test odds = 0.05 / (1 − 0.05) = 0.05263
Step 3:
Calculate post-test odds:
Post-test odds = 0.05263 × 18.0 = 0.9474
Result:
Post-test probability = 0.9474 / (1 + 0.9474) = 0.4864 = 48.64%
Despite a positive test with 90% sensitivity, the actual probability of having COVID-19 is only about 49% due to the low prevalence (5%). This demonstrates the importance of considering base rates!

Frequently Asked Questions

Why doesn't a positive test mean I definitely have the disease?

Tests aren't perfect. False positives occur, especially when disease prevalence is low. A positive test increases your probability, but the actual chance depends on sensitivity, specificity, and how common the disease is in your population.

What's a good likelihood ratio?

LR+ > 10 or LR− < 0.1 are considered strong evidence. LR+ between 5-10 or LR− between 0.1-0.2 are moderate. LR+ between 1-5 or LR− between 0.2-1 provide weak evidence. LR = 1 means the test is useless.

When should I use pre-test probability vs prevalence?

Use prevalence (population rate) when you have no other information. Use higher pre-test probability if the patient has symptoms or risk factors. Clinical judgment can adjust the pre-test probability above or below population prevalence.

Why use likelihood ratios instead of sensitivity/specificity directly?

Likelihood ratios combine sensitivity and specificity into a single number that directly indicates how much the test changes disease probability. They work regardless of prevalence and can be easily chained for multiple tests.

Can I use this calculator for positive AND negative results?

Yes! Simply select the test result (Positive or Negative). The calculator automatically uses the appropriate likelihood ratio (LR+ for positive, LR− for negative) to compute the correct post-test probability.

What if I have multiple tests?

For independent tests, use the post-test probability from the first test as the pre-test probability for the second test. Multiply likelihood ratios together: post-test odds = pre-test odds × LR₁ × LR₂ × ...

What's the difference between odds and probability?

Probability ranges from 0 to 1 (or 0% to 100%). Odds range from 0 to infinity. Probability = Odds / (1 + Odds). Odds = Probability / (1 − Probability). Odds are used in the middle steps of calculations.

Is this the same as Bayes' theorem?

Yes! This is a practical application of Bayes' theorem, specifically the likelihood ratio form. It updates prior beliefs (pre-test probability) with new evidence (test result) to get posterior beliefs (post-test probability).

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