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Fagan Nomogram and Post-Test Probability Calculator

Work out how much a positive or negative test result changes the probability of disease. Enter the pre-test probability and the test's likelihood ratios, or its sensitivity and specificity.

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Test accuracy given as
Pre-test probability (%)Likelihood ratioPost-test probability (%)0.10.10.20.20.50.511225510102020303040405050606070708080909095959898999999.599.599.899.899.999.90.0010.0050.010.050.10.20.512510201002001000Positive test (LR+ = 4.50): post-test 52.9%Negative test (LR− = 0.125): post-test 3.0%

Results

Post-test probability if positive52.9%LR+ = 4.50
Post-test probability if negative3.0%LR− = 0.125
Pre-test odds0.250Post-test odds = pre-test odds × LR
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How to Use the Fagan Nomogram Calculator

  1. 1

    Enter the pre-test probability

    Prevalence or clinical judgement.

  2. 2

    Enter the test accuracy

    Sensitivity and specificity, or likelihood ratios.

  3. 3

    Read the post-test probabilities

    And download the nomogram.

How the Fagan nomogram works

Fagan's nomogram applies Bayes' theorem graphically: a straight line from the pre-test probability through the likelihood ratio gives the post-test probability.

Likelihood ratios well above 1 raise the probability of disease after a positive result, and ratios well below 1 lower it after a negative result. The same test is much more informative in some settings than others because the pre-test probability matters.

How it is calculated

Sources

Fagan Nomogram Calculator: FAQ

What is a good likelihood ratio?

The further from 1, the more a result changes the probability. How much change is useful depends on the pre-test probability and the clinical decision.

Can I use pooled estimates from a diagnostic meta-analysis?

Yes. Enter the pooled sensitivity and specificity, or pooled likelihood ratios, to show what the test means in practice.

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