¿Son la sensibilidad y la especificidad medidas obsoletas para determinar la bondad de una prueba diagnóstica?

Noel Antonio Sánchez T

doi:10.17533/udea.rfnsp.887

Are sensitivity and specificity obsolete measures to determine the convenienceof a diagnostic test?

Authors

Noel Antonio Sánchez T Universidad de Antioquia

DOI:

https://doi.org/10.17533/udea.rfnsp.887

Keywords:

Diagnostic tests, Bayes’s theorem, sensitivity, specificity predictive values, likelihood ratios, prevalence, odds

Abstract

In the present article a discussion on the advantages ascribed by some authors to the new concepts of likelihood ratios with respect to the classic concepts of sensitivity and specificity, important concepts used for evaluating diagnostic tests in the field of clinical epidemiology, is shown. With the aim of illustrating the advantages and disadvantages of each one of these conceptualizations, the post-test probabilities for different prevalences and categorical levels are calculated by means of Bayes’s Theorem, in the case of the

classic concepts, and by means of odds, in the case of the modern concepts, taking as example the results of a systematic review of serum ferritin as a diagnostic test for iron deficiency. As a result all the likelihood ratio

s as well as sensitivity and specificity allow calculating the post-test probability for different prevalences, can be obtained for test of two or more results, stay unchanged in front of changes in disease prevalence, they also and allow the quickly convertion of the pretest probability in post-test probability by means of Fagan nomogram. It is concluded that the new concepts as well as the former ones are useful for evaluating the goodness of a diagnostic test and that, for this purpose, all of them can be considered as equivalents. It just depends upon more subjective aspects and considerations, like concept comprehension and remembering, to choose a view instead of the other one.

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Author Biography

Noel Antonio Sánchez T, Universidad de Antioquia

Profesor Facultad Nacional de Salud Pública

References

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Published

2009-03-06

How to Cite

Sánchez T NA. Are sensitivity and specificity obsolete measures to determine the convenienceof a diagnostic test?. Rev. Fac. Nac. Salud Pública [Internet]. 2009 Mar. 6 [cited 2025 Jan. 31];20(1). Available from: https://revistas.udea.edu.co/index.php/fnsp/article/view/887

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Issue

Vol. 20 No. 1 (2002)

Section

Revisión sistemática

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