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If the patient group represented by 1 % prevalence shown in Table?3 is part of a screening programme, then obviously it is desirable to have both sensitivity and specificity as high as possible. Then both true-positive and true-negative outcomes would be high and the associated cost detriment arising from false-positive/false-negative outcomes low. However, it can be deduced that a sensitive examination is more valuable when false-negative selleck screening library outcomes are more undesirable than false-positive ones. However, high specificity is more valuable if false-positive outcomes are more undesirable. X-ray examinations applied to a low-prevalence group of patients that is not part of a screening programme will spend much of its resources in verifying negative disease status (the worried well syndrome) in order to detect a relatively low number of positive outcomes (Table?3). Equally, when the sensitivity or specificity = 0.5 the true-positive or true-negative outcomes are matched or neutralised by equal numbers of false-negative or false-positive outcomes, respectively, and the net diagnostic cost benefit is zero. The diagnostic process is then operating under conditions of maximum uncertainty and essentially providing random outcomes operating on the diagonal of the appropriate receiver operating characteristic (ROC) space. Sensitivity and specificity in diagnostic radiology What are typical sensitivities and specificities arising from diagnostic X-ray examinations? Ixazomib manufacturer A detailed study of the role of digital chest radiography in the screening for lung cancer demonstrated the sensitivities and specificities that might be expected from radiographic examinations as well as the role of observer performance in determining these outcome measures(10). This study concluded that a detection rate of 94 % for lung tumours with a diameter in the range of 6.8�C50.7 mm (as verified by CT) was achievable with chest radiography only at the expense of a high false-positive rate requiring an excessive number of workup CT examinations. Typically, over 50 workup CT examinations (false positives) were required per cancer Thalidomide detected in order to achieve a sensitivity of ?70 % and specificity