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In medical diagnosis, test sensitivity is the ability of a test to correctly identify those with the disease (true positive rate), whereas test specificity is the ability of the test to correctly identify those without the disease (true negative rate). If 100 patients known to have a disease were tested, and 43 test positive, then the test has ...
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 ]
Note that the positive and negative predictive values can only be estimated using data from a cross-sectional study or other population-based study in which valid prevalence estimates may be obtained. In contrast, the sensitivity and specificity can be estimated from case-control studies.
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 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, :
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 addition to sensitivity and specificity, the performance of a binary classification test can be measured with positive predictive value (PPV), also known as precision, and negative predictive value (NPV). The positive prediction value answers the question "If the test result is positive, how well does that predict an actual presence of ...
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%.