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Questions and Answers

What is a diagnostic test?

A diagnostic test refers to procedures used to confirm or refute the presence or absence of a disease, including taking medical history, observing signs and symptoms, and imaging.

A test is considered perfect if it shows a positive result for all patients without the disease.

False

What type of study design collects data from a group of participants at a single point in time?

Cross-sectional study design.

What is a gold standard test?

<p>A gold standard test is a definitive diagnostic test or benchmark for diagnosing a disease process.</p> Signup and view all the answers

Sensitivity is the ability of a test to correctly classify an individual as _______.

<p>diseased</p> Signup and view all the answers

Specificity is the ability of a test to correctly classify an individual as _______.

<p>disease-free</p> Signup and view all the answers

What is Positive Predictive Value (PPV)?

<p>PPV is the percentage of patients with a positive test who actually have the disease.</p> Signup and view all the answers

What is Negative Predictive Value (NPV)?

<p>NPV is the percentage of patients with a negative test who do not have the disease.</p> Signup and view all the answers

The positive likelihood ratio indicates that a positive test gives significant certainty regarding the presence of disease.

<p>True</p> Signup and view all the answers

The negative likelihood ratio is interpreted as 1/NPV.

<p>True</p> Signup and view all the answers

Study Notes

Diagnostic Tests

  • Diagnostic tests are commonly used by physicians, encompassing not only laboratory assessments, but also taking medical history, observing signs and symptoms, and performing imaging.
  • These tests are used to confirm or refute the presence or absence of a disease.
  • An ideal diagnostic test would accurately identify all patients with the disease (true positives) and correctly identify all patients without the disease (true negatives).

Study Design for Diagnostic Tests

  • Cross-sectional Study Design is a research method that involves collecting data from a group of participants at a single point in time. It aims to examine relationships between variables.
    • Snapshot of a population at a specific time.
    • Surveys and measures multiple variables.
    • Quick and inexpensive.
    • Ethical to measure harm.
    • Can’t measure changes over time and causality.
    • Can be descriptive or analytical.

Gold Standard Test

  • A gold standard test or criterion standard test is considered the definitive diagnostic test in medicine.
  • It serves as a benchmark for diagnosing a disease process or evaluating scientific evidence.

Anatomy of a 2x2 Contingency Table

  • A 2x2 contingency table is used to analyze diagnostic test results and evaluate their accuracy.
  • The table compares the results of a surrogate test (the test being evaluated) to the gold standard test.

Table Layout:

  • Rows: Represent the results of the surrogate test (Positive or Negative).
  • Columns: Represent the results of the gold standard test (Positive or Negative).

Cells of the Table:

  • True Positive (a): Test is positive, and the gold standard test is also positive.
  • False Negative (c): Test is negative, but the gold standard test is positive.
  • False Positive (b): Test is positive, but the gold standard test is negative.
  • True Negative (d): Test is negative, and the gold standard test is also negative.

Different Measures of Accuracy

  • Sensitivity (positive in disease):
    • Measures the test’s ability to correctly identify individuals with the disease (true positives).
    • Calculated as a / (a+c).
    • Represents the probability of a positive test result in someone who actually has the disease.
    • Used for screening tests.
  • Specificity (negative in health):
    • Measures the test’s ability to correctly identify individuals without the disease (true negatives).
    • Calculated as d / (b+d).
    • Represents the probability of a negative test result in someone who does not have the disease.
    • Used for confirmatory tests.
  • Positive Predictive Value (PPV):
    • Represents the percentage of patients with a positive test who actually have the disease.
    • Calculated as a / (a+b).
    • Indicates the probability of having the disease when the test is positive.
  • Negative Predictive Value (NPV):
    • Represents the percentage of patients with a negative test who do not have the disease.
    • Calculated as d / (c+d).
    • Shows the probability of not having the disease when the test is negative.
  • Positive Likelihood Ratio:
    • Measures the amount of certainty gained after a positive test result.
    • Interpreted as the ratio of the likelihood of a positive test in someone with the disease compared to someone without the disease.
  • Negative Likelihood Ratio:
    • Measures the amount of certainty gained after a negative test result.
    • Interpreted as the ratio of the likelihood of a negative test in someone with the disease compared to someone without the disease.
    • A likelihood ratio close to 1 suggests the test provides little additional information about the disease.

Guide

  • SNOUT:
    • High SeNsitivity helps to RULE OUT a disease.
    • A negative test result in a highly sensitive test is more likely to be true.
  • SPIN:
    • High SPecificity helps to RULE IN a disease.
    • A positive test result in a highly specific test is more likely to be true.

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