Editor,—We read with interest the study by Smytheet al (Gut1998;43:571–4); however, we feel that on the basis of the data presented, the pronouncement of death for the test may perhaps be a little premature.

Firstly, despite the low sensitivity and specificity reported, the test still had positive and negative predictive values (66.7 and 57% respectively) which would be clinically useful in allowing patients to come to an informed decision regarding cholecystectomy.

Secondly, the authors conclude that there is no statistical difference between the positive and negative test groups in terms of their outcome after cholecystectomy. The relative …