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Sensitivity, Specificity, PPV, NPV

• These 4 measures describe how well diagnostic

tests capture the true presence or absence of
disease
• Sensitivity (SN)
◦ % with disease who test positive
◦ = a/(a+c) = TP/(TP+FN)
• Specificity (SP)
◦ % without disease who test negative
◦ = d/(b+d) = TN/(FP+TN)
• Positive predictive value (PPV)
◦ % positive test results that are true positives
◦ = a/(a+b) = TP/(TP+FP)
Y axis: sensitivity

• Negative predictive value (NPV)

◦ % negative test results that are true
negatives
◦ = d/(c+d) = TN/(FN+TN)
• Cut-off point may be adjusted to optimize
sensitivity and specificity, which are inversely
related (cut-off point with decreased sensitivity
is associated with increased specificity and vice-versa)
• Receiver operating characteristic (ROC) curves are a graphical depiction of a test's
performance
◦
◦ X axis: 1-specificity
◦ The higher the curve, the better the test
◦ This is quantified by the AUC (area under the curve); an AUC of 0.5 states
that the test performs no better than chance (bad test!), whereas an AUC of
0.9 suggests a better-performing test

Odds Ratio, Relative Risk, Attributable Risk, Absolute Risk Reduction


• These
 measures describeEvidence
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between a risk factor and a disease
• Odds Ratio (OR)
◦ odds of having disease in expose group /
odds of having disease in unexposed
group
◾ = ad/bc
• Relative Risk (RR)
◦ probablity of getting disease in exposed
group / probability of getting disease in unexposed group
◾ = [a/(a+b)] / [c/(c+d)]
• Attributable Risk (AR)
◦ risk in exposed group - risk in unexposed group
◾ = a/(a+b) - c/(c+d)
• Absolute Risk Reduction (ARR)
◦ risk in control group - risk in intervention group
◾ = c/(c+d) - a/(a+b)

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 Login to View Community Videos 10/30/2012

Evaluation of Diagnostic Tests
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Derek Moore

 Stats- 2x2 Tables (SN, SP, PPV, NPV, OR, RR)

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 Login to View Community Videos 8/8/2012

Statistic definition review
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Derek Moore

 Stats- 2x2 Tables (SN, SP, PPV, NPV, OR, RR)

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