Specificity and Sensitivity

BMS 2143 Clinical Biochemistry

Omila Perera
MSc Biotechnology (UK), BSc (Hons) Biomedical Science (UK)
omila.perera@cinec.edu
 Laboratory test results

• The clinical laboratory has a responsibility in providing clinicians with

adequate information that can assist them in the correct interpretation of
the data.
• The laboratory result must be interpreted on the background of a
reference interval that is used to distinguish between “health” and
disease”.
• The clinician must also evaluate the result from the knowledge of
biological variation and be aware of the potential risk of false
interpretation.
• Likewise, influence of random errors and systematic errors on the result
is of importance as well as the diagnostic sensitivity and specificity.
 Laboratory test results

Positive results
• Mean that the substance or condition being tested for was found.
• Also can mean that the amount of a substance being tested for is higher or
lower than normal.

Negative results
• A negative test result mean that the substance or condition being tested for
was not found.
• Negative test results can also mean that the substance being tested for was
present in a normal amount.

Inconclusive results
• Results are not clearly positive or negative.
False Positive test result
• A test result that indicates that a person has a specific disease or
condition when the person actually does not have the disease or
condition.

False Negative test result

• A test result that is incorrect because the test failed to recognize an
existing condition or finding.
Accuracy
• The accuracy is a measure of the degree of closeness of a measured
value to its actual value.
Precision
• Precision measures how closely two or more measurements agree with
other (measure of thereproducibility of asset of measurements).
• Precision is sometimes referred to as repeatability or reproducibility.
 Experimental Error

Experimental error is the difference between a measurement and the true

value or between two measured values.
3 types of errors,

• Systemic error
• Random error
• Gross error
 Systemic errors

• Always occurs, with the same value, when we use the instrument in the
same way and in the same case.
• May often be reduced with standardized procedure.
• Systematic error is predictable and typically constant or proportional to
the true value.
• If the cause of the systematic error can be identified, then it usually can
be eliminated.
• Systemic errors can be 3 types (Instrument errors, Environment errors
and observation errors)
 Random errors

• Random error refers to the spread in the value of a physical quantity from
one measurement of the quantity to the next, caused by random
fluctuations in the measured value.
• Random errors are unavoidable variations that will either increase or
decrease a given measurement.
• To minimize random errors, try to use high-quality laboratory equipment
whenever possible and use consistent techniques when performing an
experiment. Since random errors are equally likely to be high as low,
performing several trials (and averaging the results) will also reduce
their effect considerably.
 Gross error
• Gross errors mainly covers the human mistakes in reading instruments
and recording and calculating measurement results.

How to avoid –
1. Great care is must in reading and recording the data.
2. Multiple reading should be taken for the quantity under measurement.
 What are the factors which define a laboratory test?

• Accuracy
• Precision
• Cost
• Interfering factors
• Reference range
• Sensitivity
• Specificity
 Terms

• True positive: the person has the disease and the test is positive.
• True negative: the person does not have the disease and the test is
negative.
• False positive: the person does not have the disease and the test is
positive.
• False negative: the person has the disease and the test is negative.
• Sensitivity is the probability that a test will indicate 'disease' among those
with the disease.
• Specificity is the fraction of those without disease who will have a
negative test results.