PerspectiveSensitivity and Specificity should be De-emphasized in Diagnostic Accuracy Studies☆
Section snippets
Limitations of Sensitivity and Specificity
In practice, the diagnostic work-up always starts with a patient presenting with particular symptoms or signs that are suggestive of a particular disease or diseases. The work-up starts with simple tests such as patient history and physical examination, which are followed by more burdensome and costly procedures. Thus a diagnostic process evolves gradually from a series of consecutive estimations of the probability of the presence of a particular disease, given the documented test results. Many
Concluding Remarks
Since sensitivity and specificity have no direct diagnostic meaning and vary across patient populations and subgroups within populations, as do posttest probabilities, there is no advantage for researchers in pursuing estimates of a test's sensitivity and specificity rather than posttest probabilities. As the latter directly reflect and serve the aim of diagnostic practice, researchers instead should focus on and report the prevalence (probability) of a disease given a test's result—Mor even
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Supported by Netherlands Organization for Scientific Research grants ZON-MW 904-66-112 and ZON-MW R 96-203.