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    2x2 Tables (SN, SP, PPV, NPV, Or, RR) - Stats - Medbullets Step

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    2x2 Tables (SN, SP, PPV, NPV, Or, RR) - Stats - Medbullets Step

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    265 views4 pages

    2x2 Tables (SN, SP, PPV, NPV, Or, RR) - Stats - Medbullets Step

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    The key takeaways are the four measures (sensitivity, specificity, positive predictive value, and negative predictive value) used to describe how well diagnostic tests work and how receiver operating characteristic curves can evaluate test performance. Additionally, odds ratio, relative risk, attributable risk, and absolute risk reduction are discussed as measures of the relationship between a risk factor and a disease.

    The four measures are sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Sensitivity measures the percentage of those with disease who test positive. Specificity measures the percentage of those without disease who test negative. PPV measures the percentage of positive tests that are true positives. NPV measures the percentage of negative tests that are true negatives.

    The four statistical measures are odds ratio (OR), relative risk (RR), attributable risk (AR), and absolute risk reduction (ARR). OR compares the odds of disease in exposed vs unexposed groups. RR compares the probability of disease in exposed vs unexposed groups. AR is the risk difference between exposed and unexposed groups. ARR is the risk reduction between a control and intervention group.

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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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    Evaluation of Diagnostic Tests
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