Sensitivity, Specificity, Predictive Values, Pre/Post-test Probability, and Likelihood Ratios explained

Sensitivity, Specificity, Predictive Values, Pre:Post-test Probability, and Likelihood Ratios explained

The purpose of this post is to explain the concept of sensitivity, specificity, predictive values, and likelihood ratios.

Screening Tests

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).  

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Euglycemic Diabetic Ketoacidosis: A Case Study

Euglycemia Diabetic Ketoacidosis: A Case Study

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 the party! In 2015, the US food and drug administration issued a drug safety communication that warned of an increased risk of DKA with uncharacteristically mild to moderate to glucose elevations (euglycemic DKA). This warning was based on diabetic medications involving SGLT-2 inhibitors. In fact this was based on 20 clinical cases requiring hospitalization captured between March 2013 and June 2014 in the FDA adverse event reporting system database. SGLT-2 inhibitors first came into market in 2013.  What are SGLT-2 inhibitor medications?

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Suturing 101: A Stitch In Time…

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 … Read more

What’s your mission?

What is your Mission_PPE

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 on me.

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What does it mean to have privileges to practice?

privilege to practice

Your Credentials

The process of credentialing can be quite a daunting one, especially if you are new to the healthcare or hospital medical staff approval process. In essence, your credentials are a verification of who you are – both academically and clinically. In addition, your credentials include your medical malpractice history, board certifications, training certificates, disciplinary actions, and other state-specific requirements that the state licensing board determines make you safe to practice. Think of your credentials as a portfolio allowing anyone who wants to know about you read a file and see what you bring to the table, and how well trained you are.

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