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Sensitivity and specificity values alone may be highly misleading. The 'worst-case' sensitivity or specificity must be calculated in order to avoid reliance on experiments with few results. For example, a particular test may easily show 100% sensitivity if tested against the gold standard four times, but a single additional test against the ...
The log diagnostic odds ratio can also be used to study the trade-off between sensitivity and specificity [5] [6] by expressing the log diagnostic odds ratio in terms of the logit of the true positive rate (sensitivity) and false positive rate (1 − specificity), and by additionally constructing a measure, :
They use the sensitivity and specificity of the test to determine whether a test result usefully changes the probability that a condition (such as a disease state) exists. The first description of the use of likelihood ratios for decision rules was made at a symposium on information theory in 1954. [ 1 ]
Youden's J statistic is = + = + with the two right-hand quantities being sensitivity and specificity.Thus the expanded formula is: = + + + = (+) (+) In this equation, TP is the number of true positives, TN the number of true negatives, FP the number of false positives and FN the number of false negatives.
The relationship between sensitivity and specificity, as well as the performance of the classifier, can be visualized and studied using the Receiver Operating Characteristic (ROC) curve. In theory, sensitivity and specificity are independent in the sense that it is possible to achieve 100% in both (such as in the red/blue ball example given above).
Diagram relating pre- and post-test probabilities, with the green curve (upper left half) representing a positive test, and the red curve (lower right half) representing a negative test, for the case of 90% sensitivity and 90% specificity, corresponding to a likelihood ratio positive of 9, and a likelihood ratio negative of 0.111.
In diagnostic testing, the main ratios used are the true column ratios – true positive rate and true negative rate – where they are known as sensitivity and specificity. In informational retrieval, the main ratios are the true positive ratios (row and column) – positive predictive value and true positive rate – where they are known as ...
The importance of specificity can be seen by showing that even if sensitivity is raised to 100% and specificity remains at 80%, the probability that someone who tests positive is a cannabis user rises only from 19% to 21%, but if the sensitivity is held at 90% and the specificity is increased to 95%, the probability rises to 49%.