My first job as a nurse practitioner was ideal. I knew all the physicians. I knew all the nurses. I knew all the administrators. Yet, I was scared beyond belief. First and for most I did not want to hurt my patients. Second, I wanted the staff that I worked with to accept me as a competent nurse practitioner. I remember clearly two conversations from those first few days; “John, don’t hurt anyone” and two, “John, one of the most important things is know what you don’t know”.
The purpose of this post is to explain the concept of sensitivity, specificity, predictive values, and likelihood ratios.
Screening tests (surveillance tests) are tools use to assess the likelihood that a patient may have a certain disease. They are not definitive, but if positive, will heighten suspicion that would warrant use of a gold standard diagnostic test to rule in or rule out a certain diagnosis. The goal of screening tests is to reduce the morbidity and mortality in a population group (Maxim, Niebo, & Utell, 2014). Examples of screening tests include routine EKGs, PSA, PAP smears, and mammograms. For example, a male with an elevated PSA may have prostate cancer, BPH, or prostatitis. Positive results of screening tests need to be compared to the established gold standard test that is regarded as definitive. In this case, a prostate biopsy is considered a definitive test, as it will reveal the etiology of the elevated PSA. Screening tests are less invasive and less costly, whereas the gold standard test may be more invasive, expensive, or too late (discovered during an autopsy). Ideally, gold standard tests, such as coronary angiography, breast biopsy, or colposcopy should have 100% sensitivity and specificity. However, in reality, this may not be the case, as it may be the best test given the clinical picture at the time (Maxim, Niebo, & Utell, 2014).
Kevin Freels, MD DKA and SGLT-2 inhibitors One of the greatest aspects of medicine that I enjoy is a continual process of learning. We must continue to grow in our profession, seeking knowledge and experience as much as possible. One such incident occurred recently while on shift… and talk about being a little late to …
Time to Suture Great! You’ve attended our course and got your first taste of suturing. You went home and practiced your suturing techniques and are feeling pretty good about your newly developed skills. Now, you’ve arrived back at the office and as you begin your shift the attending says, “Glad to see you! We are …
During a recent weekend shift in the Emergency Department, four patients presented with the same chief complaint: “I just want to know if I have the flu.”
Bunnany Pekar, CRNA, ARNP In honor of the Reverend Dr. Martin Luther King, Jr An Immigrants Story Please allow me to share my perspective on why I chose to travel across the world to provide medical care to people I do not know. But first, I am going to provide you with a little background …
