Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd
Upload
7 views

Chapter 4

Chapter 4 discusses disease screening, emphasizing the importance of validity, sensitivity, specificity, and predictive values in diagnostic tests. It defines key terms and provides formulas for calculating various metrics such as false positive rate, false negative rate, and likelihood ratios. An example is given for cognitive heart failure screening to illustrate these concepts.

Uploaded by

abdiwahab
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
7 views

Chapter 4

Chapter 4 discusses disease screening, emphasizing the importance of validity, sensitivity, specificity, and predictive values in diagnostic tests. It defines key terms and provides formulas for calculating various metrics such as false positive rate, false negative rate, and likelihood ratios. An example is given for cognitive heart failure screening to illustrate these concepts.

Uploaded by

abdiwahab
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

CHAPTER 4

DISEASE SCREENING
Screening is the search for unrecognized disease or defect by means of rapidly
applied tests, examinations or other procedures in apparently healthy
individuals.

Validity of a test is the ability to differentiate accurately between those who


have the disease and those who do not have.

An important way to view diagnostic and screening tests is through sensitivity


analysis. The definitions of relevant terms and symbols are as follows:

means positive test, means negative test, means having disease,


means not having disease.

Diagnostic test True Condition (Presence of Disease)


result Total
Yes( ) No( )
Positive ( ) a b a+b

Negative ( ) c d c+d
Total a+c b+d a+b+ c+d

Sensitivity and Specificity of a screening test


Sensitivity - is the ability of a test to identify correctly those who have the
disease. The proportion of diseased persons the test classifies as positive.

( ⁄ ), (Probability of positive test, given disease)

Specificity - is the ability of a test to identify correctly those who do not have
the disease. The proportion of nondiseased persons the test classifies as
negative.

( ⁄ ) (Probability of negative test, given no disease)

False Positive Rate (FPR): the proportion of nondiseased persons the test
classifies (incorrectly) as positive.
( ⁄ ); (probability of positive test, given nodisease)
False Negative Rate (FNR): the proportion of diseased people the test classifies
(incorrectly) as negative.

( ⁄ ); (probability of negative test given disease)


Predictive value: is the ability of a test to predict the presence or absence of
disease from test results.

Predictive Value of a Positive Test (PVPT): the proportion of positive tests that
identify diseased persons.

( ⁄ ) (Probability of no disease given positive test)

Predictive Value of a Negative Test (PVNT): the proportion of negative tests


that correctly identify nondiseased people.

( ⁄ ); (probability of no disease given negative test)

Accuracy of the Test: is the proportion of all tests that are correct
classifications

Likelihood Ratio of Positive Test: is the ratio of probability of a positive test,


given the disease, to the probability of a positive test, given no disease
( ⁄ )
, The positive test, given
( ⁄ )

disease versus positive test, given no disease.


Likelihood Ratio of Negative Test: is the ratio of probability of a negative test,
given the disease, to the probability of a negative test, given no disease.
( ⁄ )
; The negative test, given
( ⁄ )

disease versus negative test, given no disease


Example: The following table shows the screening test of individuals for
cognitive heart failure.
Disease status
Test Result Yes (+) No (-) Total
Positive 95 495 590
Negative 5 9405 9410
100 9900 10000

Compute and interpret sensitivity, specificity, FPR, FNR, PVPT, PVNT, accuracy,
LRPT and LRNT.

You might also like