Ali Muhammad Ali Rushdi, Hamzah Abdul Majid Serag

A normalized version of the ubiquitous two-by-two contingency matrix is associated with a variety of marginal, conjunctive, and conditional probabilities that serve as appropriate indicators in diagnostic testing. If this matrix is enhanced by being interpreted as a probabilistic Universe of Discourse, it still suffers from two inter-related shortcomings, arising from lack of length/area proportionality and a potential misconception concerning a false assumption of independence between the two underlying events. This paper remedies these two shortcomings by modifying this matrix into a new Karnaugh-map-like diagram that resembles an eikosogram. Furthermore, the paper suggests the use of a pair of functionally complementary versions of this diagram to handle any ternary problem of conditional probability. The two diagrams split the unknowns and equations between themselves in a fashion that allows the use of a divide-and-conquer strategy to handle such a problem. The method of solution is demonstrated via four examples, in which the solution might be arithmetic or algebraic, and independently might be numerical or symbolic. In particular, we provide a symbolic arithmetic derivation of the well-known formulas that express the predictive values in terms of prevalence, sensitivity and specificity. Moreover, we prove a virtually unknown interdependence among the two predictive values, sensitivity, and specificity. In fact, we employ a method of symbolic algebraic derivation to express any one of these four indicators in terms of the other three. The contribution of this paper to the diagnostic testing aspects of mathematical epidemiology culminates in a timely application to the estimation of the true prevalence of the contemporary world-wide COVID-19 pandemic. It turns out that this estimation is hindered more by the lack of global testing world-wide rather than by the unavoidable imperfection of the available testing methods.