Wenchang Yue, Postdoctoral Fellow at Mount Sinai Health System, shared on X:
“To check for bladder cancer, can I skip cystoscopy and use a urine test instead?
Not for now, especially for high-risk patients. Urine cytology is sensitive for high-grade disease (about 84%) and nearly useless for low-grade (about 16%).
Negative predictive value is largely set by the recurrence rate of the population, not by how good the test itself is. A marker that misses every recurrence, dropped into a population where only 15% will recur, still shows a negative predictive value of 0.85.
So when you see ‘negative predictive value 95%,’ first ask what the recurrence rate in that group was to begin with.”
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