Sensitivity and Specificity flashcards |

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True positive

-A
-Hit rate
-failed screening
= hearing loss

False positive

-B
-False alarm
-failed screening
= no loss

False negative

-C
-Miss rate
-pass screening
= hearing loss

True negative

-D
-Correct rejection
-pass screening
= no loss

Fail Screening

A. True positive (hit rate) - hearing loss
B. False positive (false alarm) - no loss

Pass Screening

C. False negative (miss rate) - hearing loss
D. True negative (correct rejection) - no loss

Screening results: hearing loss

A. True positive (hit rate) - fail
C. False negative (miss rate) - pass

Screening results: no loss

B. False positive (false alarm) - fail
D. True negative (correct rejection) - pass

Sensitivity

•Accuracy in correctly identifying disordered subjects
•Accurately identifying that they have a disorder
•A= they passed it and they do have problems
•Want to be high
•Few under-referrals
•A/(A+C)

Specificity

•Accuracy in correctly rejecting patients without disorder
•Want to be high
•Few over-referrals
•D = they passed it and they don't have a problem
•D/(B+D)

Efficiency

•Your over all accuracy
•Ability to accurately identify differentially the disorder
•Need to look at for each test we use to see how well it tells us what we want to know for example reduced sensation levels. If it is positive it has a high sensitivity; however, if it is negative it does not mean you do not have a cochlear loss so the specificity is high. You need to realize what each of your tests is saying or not saying. •(A+D)/(A+B+C+D)

When making Evidence-Based Decisions consider:

Research, clinical expertise, and client values

Evidence-Based Practice (EBP)

is not simply research support but integration of best research with clinical expertise and client values

Client Values

client's unique characteristics and circumstances

Clinician expertise

"innovators tend to be believers"

Problem with clinician factors

-paucity of research, no "gold standard"
-Huge gap in our knowledge base
-Service delivery factors

Service delivery factors

dosage, scheduling, group vs. individual, direct vs. consultative

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