# False positives, false confidence, and ebola

Designing a screening test is hard. You have a large population, almost all of whom do not have whichever condition you’re searching for. Thus, even with a tiny probability of error, most of the cases you pick up will be incorrect — false positives, in the jargon. So you try to set the bar reasonably high; but set it too high and you’ll miss most of the real cases — false negatives.

On the other hand, if you have a suspicion of the condition in a particular case, it’s much easier. You can set the threshold much lower without being swamped by false positives. What would be really dumb is to use the same threshold from the screening test to judge a case where there are individual grounds for suspicion. But that’s apparently what doctors in Spain did with the nurse who was infected with Ebola. From the Daily Beast:

When Teresa Romero Ramos, the Spanish nurse now afflicted with the deadly Ebola virus first felt feverish on September 30, she reportedly called her family doctor and told him she had been working with Ebola patients just like Thomas Eric Duncan who died today in Dallas. Her fever was low-grade, just 38 degrees Celsius (100 degrees Fahrenheit), far enough below the 38.6-degree Ebola red alert temperature to not cause alarm. Her doctor told her to take two aspirin, keep an eye on her fever and keep in touch.

She was caring for Ebola patients, she developed a fever, but they decided not to treat it like a possible case of Ebola because her fever was 0.6 degrees below the screening threshold for Ebola.

A failure of elementary statistical understanding, and who knows how many lives it will cost.