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The False-positive to False-negative Ratio in Epidemiologic Studies

Ioannidis, John P. A.a; Tarone, Robertb; McLaughlin, Joseph K.b

doi: 10.1097/EDE.0b013e31821b506e
False Positives: Original Article

The ratio of false-positive to false-negative findings (FP:FN ratio) is an informative metric that warrants further evaluation. The FP:FN ratio varies greatly across different epidemiologic areas. In genetic epidemiology, it has varied from very high values (possibly even >100:1) for associations reported in candidate-gene studies to very low values (1:100 or lower) for associations with genome-wide significance. The substantial reduction over time in the FP:FN ratio in human genome epidemiology has corresponded to the routine adoption of stringent inferential criteria and comprehensive, agnostic reporting of all analyses. Most traditional fields of epidemiologic research more closely follow the practices of past candidate gene epidemiology, and thus have high FP:FN ratios. Further, FP and FN results do not necessarily entail the same consequences, and their relative importance may vary in different settings. This ultimately has implications for what is the acceptable FP:FN ratio and for how the results of published epidemiologic studies should be presented and interpreted.

From the aStanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA; and bInternational Epidemiology Institute, Rockville, MD.

Submitted 19 October 2010; accepted 4 January 2011; posted 13 April 2011.

Editors' note: Related articles appear on pages 457, 460, 464, and 467.

Correspondence: John P. A. Ioannidis, Stanford Prevention Research Center, Stanford University School of Medicine, MSOB X306, 251 Campus Dr, Stanford, CA 94305. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.