Your test came back positive. What are the odds it is real?

A screening test that is 90% accurate sounds nearly certain. But when the condition affects 1 in 1,000 people, a positive result is right just 0.89% of the time. This calculator rebuilds that famous result with plain head counts, then sweeps the base rate so you can see exactly when a positive is worth trusting.

Health Intermediate Data Table free

After you install, this is the model to open.

Positive Test, Real Risk

  1. In your spreadsheet, click the Sortia icon in the strip of icons down the right-hand edge. No strip? Click the arrow at the bottom-right to open it. You can also use Extensions, then Sortia, then Open Sortia.
  2. Click Start from a template and put that name in the search box.
  3. Pick the card with that name and click Load this template. It arrives on a new tab with real numbers already in it.

The answer

Run the data table and Sortia sweeps the base rate from 0.1% to 50%, reporting the real probability of a true positive and the false alarms per real case at every level.

Chance a positive is real
0.89 %
False alarms per real case
111 to 1
Base rate for a coin-flip positive
10 %
Flagged per 10,000 screened
1,008 people

At a 1-in-1,000 base rate, a positive from a 90% accurate screen is real just 0.89% of the time. Screening 10,000 people flags 1,008 of them, yet only 9 truly have the condition, which is 111 false alarms for every real case. The sweep shows the flip point: the base rate must reach 10% before a positive is even a coin flip, and the test only delivers its advertised 90% when half the population already has the condition.

The model

Three rates and one population size rebuild Bayes' rule as a head count per 10,000 people screened.

Base rate (prevalence)0.10% (1 in 1,000)
True-positive rate (sensitivity)90%
False-positive rate10%
People screened10,000
Base rates tested0.1% to 50% (7 scenarios)

Once it is in your sheet

  1. The model arrives with real numbers in it and runs as it stands, so you can press the button first and understand it second.
  2. Change the numbers to yours. The sheet marks which cells are inputs and which hold formulas, and most labels carry a note explaining the row.
  3. Press the run button at the bottom of the panel. It is labeled for the tool you are in, and the result lands on its own tab, with a written reading of it beside the figures.

Never used Google Sheets? Start here goes the whole way, in seven steps, and assumes nothing.