TABLE F.2bSensitivity and Specificity of FNA

Author, YearTest for Malignant, Suspicious, FollicularIncludes All Nondiagnostic FNAs as + tests
Test for Malignant, Suspicious, Follicular, Nondiagnostic
SensitivitySpecificityLR+LR-p (cancer nodule)PPVNPVsens. w/nondiag.spec. w/nondiag.LR+LR-p (cancer nodule)PPVNPV
Cusick, 19900.760.581.840.400.580.7200.640.780.551.730.390.580.710.64
Holleman, 19950.840.521.740.310.400.5330.830.850.451.560.330.400.490.83
Jones, 19900.650.692.130.500.400.5850.750.700.521.460.580.400.460.75
Khafagi, 19880.890.723.170.150.200.4360.970.910.521.910.170.200.280.97
Lin, 19970.800.9959.580.200.310.9630.920.820.824.580.220.310.650.92
Merchant, 19950.710.918.330.310.290.7690.890.730.783.340.340.290.550.89
Piromalli, 19920.950.845.830.060.330.7400.970.950.652.720.070.330.540.97
Spiliotis, 19910.890.866.610.120.160.5560.980.900.753.660.130.160.400.98

Definitions: Sensitivity (also called true positive rate) is the “likelihood that a diseased patient has a positive test.”

Specificity (also called true negative rate) is the “likelihood that a nondiseased patient has a normal test.”

LR+ (positive likelihood ratio) = sensitivity/(false positive rate). For example, a positive likelihood ratio of 10 means that a positive test is 10 times more likely to come from a patient with disease as from a patient without disease.

LR- (negative likelihood ratio) = (false negative rate)/specificity. For example, a negative likelihood ratio of .10 means that a negative test is 1/10th as likely to come from a patient with disease than from a patient without disease.

PV+ (positive predictive value) is “the fraction of patients with a positive test result who have disease.”

PV- (negative predictive value) is “the fraction of patients with a normal test result who do not have disease.”

SOURCE: Adapted from Medical Decision Making, HD Sox, MA Blatt, MC Higgins, KI Marton, Butterworth-Heinemann, 1988.

From: Appendix F, Screening for Thyroid Cancer: Background Paper

Cover of Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests
Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications.
Institute of Medicine (US) Committee on Thyroid Screening Related to I-131 Exposure; National Research Council (US) Committee on Exposure of the American People to I-131 from the Nevada Atomic Bomb Tests.
Washington (DC): National Academies Press (US); 1999.
Copyright © 1999, National Academy of Sciences.

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