The positive predictive value of Borrelia burgdorferi serology in the light of symptoms of patients sent to an outpatient service for tick-borne diseases.
OBJECTIVE
By using the published incidence of Lyme borreliosis in endemic regions of the World, and the sensitivity and specificity data of the best Lyme serological tests, we computed the positive predictive value of Borrelia burgdorferi antibody testing.


METHODS
The calculation of predictive value was based on Bayes' theorem. We also analyzed the frequency distribution of the specific and non-specific symptoms and complaints of 27,194 patients sent to the Centre for Tick-borne Diseases in Budapest from 1986 to 2008.


RESULTS
This evaluation demonstrated that practitioners often use Lyme serology in a "trial and error" way, without any reasonable ground. According to our calculation the positive predictive value of the best Lyme antibody tests if applied in this way is <9.1%.


CONCLUSIONS
Our study suggests that the present practice of applying Lyme serological tests may result in more harm than benefit.
Lakos
András
A
The Centre for Tick-Borne Diseases, Budapest, Hungary. alakos@t-online.hu
Reiczigel
Jeno
J
Solymosi
Norbert
N
D000554:Ambulatory Care Facilities; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood*; D001499:Bayes Theorem; D025065:Borrelia burgdorferi / Q000276:immunology*; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000592:standards*; D017282:Tick-Borne Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology
D000907:Antibodies, Bacterial
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