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Specificity (true negative rate) is the probability of a negative test result, conditioned on the individual truly being negative. If the true status of the condition cannot be known, sensitivity and specificity can be defined relative to a " gold standard test " which is assumed correct.
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 ]
The negative predictive value is defined as: = + = where a "true negative" is the event that the test makes a negative prediction, and the subject has a negative result under the gold standard, and a "false negative" is the event that the test makes a negative prediction, and the subject has a positive result under the gold standard.
Specificity (SPC) or True Negative Rate (TNR) is the proportion of people that tested negative and are negative (True Negative, TN) of all the people that actually are negative (Condition Negative, CN = TN + FP). As with sensitivity, it can be looked at as the probability that the test result is negative given that the patient is not sick. With ...
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.
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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.
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