Examination and History
Taking Ch. 1-5 2026 Expert
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Validity - ANSWER ✔✔Does the test accurately identify whether a
patient has a disease?
This involves comparing the test against a "gold standard" (the best
measure of wether a patient has disease).
,The initial step in evaluating a diagnostic test.
Sensitivity - ANSWER ✔✔The probability that a person with disease
has a POSITIVE test.
Also known as the "true positive" rate.
Useful for screening tests because if sensitivity is > 90%, you can rule
OUT diseases (test is rarely negative when the disease is present)
Ex) The probability that a patient with splenomegaly is associated with
percussion dullness below the left costal margin.
Specificity - ANSWER ✔✔The probability that a non-diseased person
has a NEGATIVE test.
Also known as the "true negative" rate.
Useful as confirmatory tests because if specificity is >90%, it is safe to
confirm diseases (test is rarely positive when the disease is absent)
, Ex) The probability that a patient WITHOUT splenomegaly will have
percussion dullness is the false positive rate for this physical maneuver.
A negative result from a test with high sensitivity... - ANSWER
✔✔...usually means you can exclude the disease.
(high sensitivity = very low false-negative rate)
SnNOUT Acronym - ANSWER ✔✔a Sensitive test with a Negative
result rules OUT disease
SpPIN Acronym - ANSWER ✔✔a Specific test with a Positive result
rules IN disease
Positive Predictive Value (PPV) - ANSWER ✔✔The probability that a
person with a positive test has disease [a / (a + b)]
Ex) Prostate Cancer screening, where a man with a PSA value greater
than 4.0 ng/mL has only a 30% probability of having prostate cancer
when tested via biopsy.
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