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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 November 17; 335(7628): 1008.
PMCID: PMC2078675
Lyme Wars

Let's tackle the testing

Raphael B Stricker, past president1 and Lorraine Johnson, executive director2

The two tier testing system endorsed by the Centers for Disease Control and Prevention (CDC) has a high specificity (99%) and yields few false positives. But the tests have a uniformly miserable sensitivity (56%)—they miss 88 of every 200 patients with Lyme disease (table(table).). By comparison, AIDS tests have a sensitivity of 99.5%—they miss only one of every 200 AIDS cases. In simple terms, the chance of a patient with Lyme disease being diagnosed using the commercial tests approved by the Food and Drug Administration and sanctioned by the CDC is about getting heads or tails when tossing a coin, and the poor test performance assures that many patients with Lyme disease will go undiagnosed.

Sensitivity and specificity of commercial two tier testing for Lyme disease

Until we scrap the worthless commercial tests for Lyme disease and find a better way to make the diagnosis of this protean illness, the “Lyme wars” will continue unabated.1


Competing interests: RBS serves on the advisory panel for QMedRx.


1. Tonks A. Lyme wars. BMJ 2007;335:910-2. (3 November.) [PMC free article] [PubMed]

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