Sensitivity & Specificity

Sensitivity
is the ability of a measure to identify a

case correctly, that is, to diagnose a condition correctly. True positive

Formula:

Sensitivity= true positives/(true positive + false negative)

Specificity
is the ability of a measure to identify a

non-case correctly, that is, to screen out those without the condition correctly. True negative
Formula: Specificity=true negatives/(true negative +

false positives)

Positive predictive value (PPV)

is the probability that the disease is present

when the test is positive Formula: PPV= true positive/(true positive + false positive)

Negative predictive value (NPV)

is probability that the disease is not present

when the test is negative.

Formula:

NPV= true negatives/(true negatives +false negatives)

Likelihood Ratio

Positive likelihood ratio

Ratio between the probability of a positive

test result given the presence of the disease and the probability of a positive test result given the absence of the disease
Formula:

True positive rate / False positive rate = Sensitivity / (1-Specificity)

Negative likelihood ratio

Ratio between the probability of a negative

test result given the presence of the disease and the probability of a negative test result given the absence of the disease.
Formula:

False negative rate / True negative rate = (1Sensitivity) / Specificity

Example:
Suppose we wanted to evaluate whether

adolescents self-reports about their smoking were accurate and we asked 100 teenagers about whether they had smoked cigarette in the previous 24 hours. The gold standard for nicotine consumption is cotinine levels in a body fluid, and so lets assume that we get their urinary cotinine.

Self-reported Smoking

Positive (Cotinine > Negative (Cotinine 200 ng/mL) < 200 ng/mL)

Yes, smoked

A (True Positive) 20

B (False Positive) 10

No, did not smoke

C (False Negative) 20

D (True Negative) 50

SOLVE FOR:
Sensitivity
Specificity Positive predictive value (PPV)

Negative predictive value (NPV)

Positive likelihood ratio

Negative likelihood ratio

Computation
Sensitivity
Given: true positives: 20, false negative : 20

Sensitivity= true positives/(true positive + false negative) = 20/(20+20) = 20/40 = 0.50 or 50%

 Specificity
Given:true negative= 50,

false positives=10 Specificity=true negatives/(true negative + false positives) = 50/ (50+10) =50/60 = 0.83 or 83%

 Positive predictive value (PPV)

Given:true positive= 20, false positive= 10

PPV= true positive/(true positive + false positive) = 20/(20+10) = 20/30 =0.67 X 100 = 67 %

 Negative predictive value Given:true negatives= 50

false negatives=20 NPV=true negatives/(true negatives +false negatives) =50/(50+20) =50/70 =0.71 x 100 = 71 %

 Positive likelihood ratio Given: Sensitivity= 50, Specificity=83

True positive rate / False positive rate = Sensitivity / (1-Specificity) =0.50/ (1-0.83) = 0.50/ 0.17 = 2.94

 Negative likelihood ratio Given: Sensitivity= 0.50, Specificity= 0.83

False negative rate / True negative rate = (1Sensitivity) / Specificity = (1-0.50) / 0.83 = 0.50/ 0.83

THE RESULT
Sensitivity = 0.50
Specificity = 0.83 Positive predictive value (PPV) =0.67

Negative predictive value (NPV) = 0.71

Positive likelihood ratio =2. 94

Negative likelihood ratio= 0.60