Clinical Assessment & Techniques

BMED 485
 CHAPTER 1 :
Laboratory Tests
Laboratory Tests
Laboratory Tests
Performance characteristics of a test
in a laboratory setting :

Sensitivity
Specificity
Precision
Accuracy
Predictive Value
Population with affected and non-
affected individuals
Affected
Non-affected
A perfect diagnostic test identifies the affected
individuals only
Affected
Non-affected
In reality, tests are not perfect

Affected
Non-affected
Sensitivity of a test

The sensitivity of a test is the ability of the test to identify correctly the
affected individuals

Proportion of persons testing positive among affected

individuals

Affected persons

Test result
+ True positive (TP)

- False negative (FN)

Sensitivity (Se) = TP / (TP + FN)

Example: Sensitivity a new ELISA IgM test
for acute EBV infection

Patients with acute EBV infection

+ True positive (TP) 148
ELISA IgM test result
- False negative (FN) 2
150

Sensitivity =
TP / (TP + FN)
148 / 150 = 98.7%
Specificity of a test
The specificity of a test is the ability of the test to identify correctly non-
affected individuals

Proportion of persons testing negative among non-affected

individuals

Non-affected persons

Test result
+ False positive (FP)

- True negative (TN)

Specificity (Sp) = TN / (TN + FP)

 Specificity of a new ELISA IgM test
for acute EBV infection

Persons without acute EBV infection

+ False positive (FP) 10
ELISA IgM test result
- True negative (TN) 190
200

Specificity =
TN / (TN + FP)
190 / 200 = 95%
 Performance of a test
Disease
Yes No

+ TP FP

Test

- FN TN

TP TN
Se = Sp =
TP + FN TN + FP

15
Purposes of Laboratory Tests
Phases of Laboratory Work
CHAPTER 2 :
Phlebotomy
Blood Collection Tubes