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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.
Recall in this context is also referred to as the true positive rate or sensitivity, and precision is also referred to as positive predictive value (PPV); other related measures used in classification include true negative rate and accuracy. [12] True negative rate is also called specificity.
The positive predictive value (PPV), or precision, is defined as = + = where a "true positive" is the event that the test makes a positive prediction, and the subject has a positive result under the gold standard, and a "false positive" is the event that the test makes a positive prediction, and the subject has a negative result under the gold standard.
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).
In clinical practice, post-test probabilities are often just estimated or even guessed. This is usually acceptable in the finding of a pathognomonic sign or symptom, in which case it is almost certain that the target condition is present; or in the absence of finding a sine qua non sign or symptom, in which case it is almost certain that the target condition is absent.