SENSITIVITY & SPECIFICITY EXERCISE

(50 pts.)

Question 1

The prevalence of previously undetected diabetes in a population to be screened is

approximately 1.5% and it is assumed that 10,000 persons will be screened. The screening test
will measure blood serum sugar content. A value of 180 mg percent or higher is considered
positive. The sensitivity and the specificity associated with this screening are 22.9% and 99.8%
respectively.
a. Set up a two by twotable with the appropriate numbers in each cell of the table. Round
to the nearest whole number, but only after you have completed all the calculations
down through and including item f). (1 pt. per box including totals)

ills wells Total subjects

Pos tests 34 20 54

Neg tests 116 9830 9946

150 9850 10000

Total tests

Prevalence = 1.5%
Population = 10,000
Sensitivity = 22.9%
Specificity = 99.8%

Calculate the following values: (2 pts. each)

b. The percentage of false positives among all those without disease (the type I error rate).

c. The percentage of false negatives among all those with disease (the type II error rate).

d. The predictive value of a positive test.

e. The predictive value of a negative test.

 f. Based on the calculations above, how many false positives and negatives will occur if
100,000 people are screened?

Question 2

To observe the effect of increasing sensitivity, assume a blood sugar screening level of 130 mg
percent, with a sensitivity of 44.3% and a specificity of 99.0%. Set up a two by twotable with the
appropriate numbers in each cell. Calculate the following values when the number of persons
screened is 10,000 and the prevalence of undetected diabetes is 1.5%. Round to the nearest
whole number, but only after you have completed all the calculations down through and
including item e). (1 pt. per box including totals)

ills wells Total people

Pos tests 66 98 164

Neg tests 84 9752 9836

150 9850 10000

Total tests

Calculate the following values:

a. The percentage of false positives among all those without disease (the type I error rate).
(2 pts.)

b. The percentage of false negatives among all those with disease (the type II error rate). (2
pts.)

c. The predictive value of a positive test. (2 pts.)

d. The predictive value of a negative test. (2 pts.)

e. Based on the calculations above, how many false positives and false negatives will occur
if 100,000 people are screened? (2 pts.)

f. Explain the clinical significance of a diagnostic tests sensitivity and specificity. Be

specific in your explanation by using a diagnostic test as an example. (6 pts.)

g. If you were the director for the diabetes screening program would you prefer to screen at
130 mg or 180 mg percent? Explain why. (6 pts.)