Lupus, also known as systemic lupus erythematosus (SLE), is a chronic autoimmune disease in which the immune system mistakenly attacks healthy tissues and organs. The exact cause is unknown, but potential triggers include genetics, hormones (it is more common in women of childbearing age), and environmental factors such as sunlight, infections, stress, and certain medications. While there is no cure, treatment can control symptoms and prevent organ damage.
In hypothesis testing, the process of diagnosing lupus can be expressed as:
• H₀ (Null hypothesis): The patient does not have lupus.
• H₁ (Alternative hypothesis): The patient has lupus.
In medical diagnosis, two types of errors can occur:
Type I error (false positive) happens when someone is diagnosed with lupus even though they don’t actually have it. This can lead to unnecessary treatment, which may harm the body. Medicines used for lupus are often strong, so they can overwork the liver as it processes them, increasing the risk of liver damage. The kidneys can also be strained from filtering drugs that aren’t needed. Strong medications like steroids may weaken the immune system, making infections more likely, and long-term use can cause bone loss, weight gain, high blood pressure, or diabetes. Other drugs may damage the eyes (retinopathy), and anti-inflammatory medicines can cause stomach ulcers or bleeding.
Type II error (false negative) is when someone actually has lupus but is told they don’t. Without proper treatment, the disease keeps progressing and can cause serious organ damage. Kidneys may develop lupus nephritis, leading to kidney failure. The heart can become inflamed or develop a higher risk of heart attack. The lungs may be damaged or inflamed, causing breathing problems. Lupus can also affect the brain and nervous system, leading to seizures, strokes, memory loss, or mood changes. It may damage the blood and bone marrow, causing anemia or clotting problems. On the outside, it can cause ongoing skin rashes or ulcers, and in the joints, it can lead to painful, chronic arthritis.
Trade-off between Type I and Type II Errors in Lupus Diagnosis
In medicine, doctors must balance the risk of over-diagnosing (Type I error) with the risk of missing the diagnosis (Type II error). While Type I errors can result in unpleasant side effects, financial costs, and temporary health risks from unnecessary treatment, they are often reversible. A patient can return for follow-up visits, seek a second opinion, and stop treatment if the misdiagnosis is identified. Type II errors, however, can be far more dangerous in the case of lupus. Because the disease may progress silently, patients might feel healthy while lupus continues to damage vital organs such as the kidneys, heart, lungs, and brain. By the time the correct diagnosis is made, the damage could be irreversible, leading to lifelong disability or even death. For this reason, in diseases like lupus where early treatment is critical, it is generally safer to minimize Type II errors even if that means accepting a slightly higher risk of Type I errors. In other words, it is often better to risk over-treating a healthy patient than to miss lupus in someone who truly has it.
Top comments (0)