Specificity (tests)
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
The specificity is a statistical measure of how well a binary classification test correctly identifies the negative cases, or those cases that do not meet the condition under study. For example, given a medical test that determines if a person has a certain disease, the specificity of the test to the disease is the probability that the test indicates `negative' if the person does not have the disease.
That is, the specificity is the proportion of true negatives of all negative cases in the population. It is a parameter of the test.
High specificity is important when the treatment or diagnosis is harmful to the patient mentally and/or physically.
Worked example
- Relationships among terms
| Condition (as determined by "Gold standard") | ||||
| True | False | |||
| Test outcome | Positive | True Positive | False Positive (Type I error, P-value) | → Positive predictive value |
| Negative | False Negative (Type II error) | True Negative | → Negative predictive value | |
| ↓ Sensitivity | ↓ Specificity | |||
- A worked example
- the Fecal occult blood (FOB) screen test is used in 203 people to look for bowel cancer:
| Patients with bowel cancer (as confirmed on endoscopy) | ||||
| True | False | ? | ||
| FOB test | Positive | TP = 2 | FP = 18 | = TP / (TP + FP) = 2 / (2 + 18) = 2 / 20 ≡ 10% |
| Negative | FN = 1 | TN = 182 | = TN / (TN + FN) 182 / (1 + 182) = 182 / 183 ≡ 99.5% | |
| ↓ = TP / (TP + FN) = 2 / (2 + 1) = 2 / 3 ≡ 66.67% | ↓ = TN / (FP + TN) = 182 / (18 + 182) = 182 / 200 ≡ 91% | |||
Related calculations
- False positive rate (α) = FP / (FP + TN) = 18 / (18 + 182) = 9% = 1 - specificity
- False negative rate (β) = FN / (TP + FN) = 1 / (2 + 1) = 33% = 1 - sensitivity
- Power = 1 − β
Hence with large numbers of false positives and few false negatives, a positive FOB screen test is in itself poor at confirming cancer (PPV=10%) and further investigations must be undertaken, it will though pickup 66.7% of all cancers (the sensitivity). However as a screening test, a negative result is very good at reassuring that a patient does not have cancer (NPV=99.5%) and at this initial screen correctly identifies 91% of those who do not have cancer (the specificity).
Definition
A specificity of 100% means that the test recognizes all healthy people as healthy. The maximum is trivially achieved by a test that claims everybody healthy regardless of the true condition. Therefore, the specificity alone does not tell us how well the test recognizes positive cases. We also need to know the sensitivity of the test to the class, or equivalently, the specificities to the other classes.
A test with a high specificity has a low Type I error rate.
Specificity is sometimes confused with the precision or the positive predictive value, both of which refer to the fraction of returned positives that are true positives. The distinction is critical when the classes are different sizes. A test with very high specificity can have very low precision if there are far more true negatives than true positives, and vice versa.
See also
- binary classification
- receiver operating characteristic
- sensitivity (tests)
- statistical significance
- Type I and type II errors
- Selectivity
Online Calculators
References
- Altman DG, Bland JM (1994). "Diagnostic tests. 1: Sensitivity and specificity". BMJ 308 (6943): 1552. PMID 8019315.
External links
- Sensitivity and Specificity Medical University of South Carolina
he:סגוליות ja:特異度su:Spésifisitas ur:خصوصیت
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
