Plain Language · Decision-Making

Conditional Probability
for Normal Humans

If you test positive for malaria, how likely is it that you are actually sick? Many doctors don't even understand the answer. Here's an explanation without complicated formulas.

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This important concept is usually taught with horrific formulas — here's an intuitive explanation instead. Conditional probability lets you answer important questions like: given that I tested positive for malaria, how likely is it that I actually have malaria? So, as you can imagine, it's pretty important that doctors and nurses understand how it works.

The problem is, most schools teach conditional probability (also known as Bayes) in an incoherent way with a terrible formula. So, doctors memorize it for a statistics class, then promptly forget it. There's a better way that lets you avoid the formulas altogether and get the same results.

Here's an example.¹

Let's assume:

The question is: I just took a malaria test, and it said that I am sick. What are the odds that I actually am sick?

Intuitively, I would guess that the odds are somewhere around 1%. Actually, it's closer to 50%.

Here's how you get there. Let's make up an example with specific numbers — the trick is to actually do the math. Here's the breakdown for a group of 1 million people:

Group Population Tests positive
Have malaria (1% of 1M) 10,000 10,000 (100%)
Don't have malaria (99% of 1M) 990,000 9,900 (1%)
Total 1,000,000 19,900

For this example, I've gone through and plugged in the percentages and the numbers. So, since 1% of the population as a whole have malaria, and we have 1 million people, 1% of 1 million is 10,000 people have malaria. I picked one million because it's a nice round number that makes the calculations easier.

My question is: I tested positive for malaria, so what are the odds that I am actually sick? Well, you need two numbers for this:

Let's calculate those two numbers:

Out of all the people who tested sick, what percentage have malaria?
10,000 / 19,900 = 50.3%

I only have a 50% chance of actually being sick! So, why do we get such strange results? It's because the overall percentage of people who have malaria is so low. Because only 1% of the population has malaria, the number on the top of our fraction (10,000) is also low.

You get much more intuitive seeming results if you look at a more common disease. Here are the numbers for an illness that half the population has:

Group Population Tests positive
Have illness (50% of 1M) 500,000 500,000 (100%)
Don't have illness (50% of 1M) 500,000 5,000 (1%)
Total 1,000,000 505,000

In this case, if I test sick, the odds I really am sick are a lot more intuitive:

total sick people / total people who tested sick
500,000 / 505,000 = 99%

Because the number of sick people is much higher than with malaria, they make up a much higher percentage of the people who tested sick who are actually sick.

Congratulations — you now understand test results better than most doctors do! Go forth and enjoy.

¹ These facts about malaria are not accurate — we're simplifying to make the logic easier to follow.