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    Fundamentals of Epidemiology (EPID 610) Exercise 12 Screening Learning Objectives

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    This document discusses screening tests and defines key metrics used to evaluate them, including sensitivity, specificity, positive predictive value, and negative predictive value. It provides examples of calculating these metrics based on results from screening tests for hypercholesterolemia using different cut-off points. Lowering the cut-off point increases sensitivity but decreases specificity and positive predictive value. The usefulness of screening depends on disease prevalence and characteristics of the screening test and population.

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    Fundamentals of Epidemiology (EPID 610) Exercise 12 Screening Learning Objectives

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    welcome martin
    89 views4 pages
    This document discusses screening tests and defines key metrics used to evaluate them, including sensitivity, specificity, positive predictive value, and negative predictive value. It provides examples of calculating these metrics based on results from screening tests for hypercholesterolemia using different cut-off points. Lowering the cut-off point increases sensitivity but decreases specificity and positive predictive value. The usefulness of screening depends on disease prevalence and characteristics of the screening test and population.

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    Exercise 12 Screening(1)

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    This document discusses screening tests and defines key metrics used to evaluate them, including sensitivity, specificity, positive predictive value, and negative predictive value. It provides examples of calculating these metrics based on results from screening tests for hypercholesterolemia using different cut-off points. Lowering the cut-off point increases sensitivity but decreases specificity and positive predictive value. The usefulness of screening depends on disease prevalence and characteristics of the screening test and population.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    89 views4 pages

    Fundamentals of Epidemiology (EPID 610) Exercise 12 Screening Learning Objectives

    Uploaded by

    welcome martin
    This document discusses screening tests and defines key metrics used to evaluate them, including sensitivity, specificity, positive predictive value, and negative predictive value. It provides examples of calculating these metrics based on results from screening tests for hypercholesterolemia using different cut-off points. Lowering the cut-off point increases sensitivity but decreases specificity and positive predictive value. The usefulness of screening depends on disease prevalence and characteristics of the screening test and population.

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    Fundamentals of Epidemiology (EPID 610)

    Exercise 12
    Screening

    LEARNING OBJECTIVES
     Define and calculate sensitivity, specificity, and positive and negative predictive value
     Discuss how the parameters of a screening tool can influence its utility
     Describe how the usefulness of screening depends on the disease, the characteristics of
    the screening test, and the population in which it will be used.

    I. Table 1 shows the results obtained in a new screening test for hypercholesterolemia (high
    cholesterol) in which 10,000 people were screened. Anyone scoring above the cut-off point of
    200 mg/dL, was classified as positive for hypercholesterolemia. These results were compared
    against a “gold standard” diagnostic test for cholesterol that is considered to be completely valid
    and reliable (i.e. the “truth”).

    Table 1
    Screening Disease No Disease Total
    Positive 125 25 150
    Negative 375 9475 9850
    Total 500 9500 10000

    1. Compute and interpret the sensitivity of the new screening test.

    2. Compute and interpret the specificity of the new screening test.

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    Fundmentals of Epidemiology (EPID 610)

    3. Compute and interpret the positive predictive value (PPV) of the new screening test.

    4. Compute and interpret the negative predictive value (NPV) of the new screening test.

    II. The screening cut-off point was then lowered to 90mg/dL. Using this cut-off point, 230
    people tested positive on the screening test. Of these, 66 people tested negative on the diagnostic
    test (that is, they did not have hypercholesterolemia). This yields Table 2.

    Table 2
    Screening Disease No Disease Total
    Positive 164 66 230
    Negative 336 9434 9770
    Total 500 9500 10000

    5. Compute the sensitivity, specificity, PPV and NPV of the screening test with the new cutoff.

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    Fundmentals of Epidemiology (EPID 610)

    6. How does lowering the screening cut-off point affect sensitivity, specificity and PPV of the
    test? Why?

    7. How does lowering the screening cut-off point affect the number of false positives and false
    negatives? What are the respective “costs” associated with false positives and false negatives?

    8. If the cut-off point were raised to 220mg/dl, how would you expect it to affect the specificity,
    sensitivity and PPV of the test?

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    Fundmentals of Epidemiology (EPID 610)

    9. Assume the prevalence of hypercholesterolemia increased from 5% to 8%. Given the same
    sensitivity and specificity of the screening test in question 5, would the PPV change and if so,
    how? (hint, construct a new 2x2 table with the new prevalence and keeping the Specificity and
    Sensitivity the same).

    Screening Disease No Disease Total


    Positive A= B= A+B=
    Negative C= D= C+D=
    Total A+C= B+D= 10000
    Fill-in the 2x2 table

    10. What factors are important in deciding if screening for a disease is worthwhile?

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