Chapter·BiostatisticsSensitivity/Specificity

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1

A 32-year-old man comes to the physician for a follow-up examination 1 week after being admitted to the hospital for oral candidiasis and esophagitis. His CD4+ T lymphocyte count is 180 cells/μL. An HIV antibody test is positive. Genotypic resistance assay shows the virus to be susceptible to all antiretroviral therapy regimens and therapy with dolutegravir, tenofovir, and emtricitabine is initiated. Which of the following sets of laboratory findings would be most likely on follow-up evaluation 3 months later? $$$ CD4 +/CD8 ratio %%% HIV RNA %%% HIV antibody test $$$

A↓ ↓ negative

B↑ ↑ negative

C↓ ↑ negative

D↑ ↓ positive

E↓ ↑ positive

2

A 36-year-old female presents to clinic inquiring about the meaning of a previous negative test result from a new HIV screening test. The efficacy of this new screening test for HIV has been assessed by comparison against existing gold standard detection of HIV RNA via PCR. The study includes 1000 patients, with 850 HIV-negative patients (by PCR) receiving a negative test result, 30 HIV-negative patients receiving a positive test result, 100 HIV positive patients receiving a positive test result, and 20 HIV positive patients receiving a negative test result. Which of the following is most likely to increase the negative predictive value for this test?

ADecreased prevalence of HIV in the tested population

BIncreased prevalence of HIV in the tested population

CIncreased number of false positive test results

DIncreased number of false negative test results

EDecreased number of false positive test results

3

A scientist in Boston is studying a new blood test to detect Ab to the parainfluenza virus with increased sensitivity and specificity. So far, her best attempt at creating such an exam reached 82% sensitivity and 88% specificity. She is hoping to increase these numbers by at least 2 percent for each value. After several years of work, she believes that she has actually managed to reach a sensitivity and specificity even greater than what she had originally hoped for. She travels to South America to begin testing her newest blood test. She finds 2,000 patients who are willing to participate in her study. Of the 2,000 patients, 1,200 of them are known to be infected with the parainfluenza virus. The scientist tests these 1,200 patients’ blood and finds that only 120 of them tested negative with her new test. Of the following options, which describes the sensitivity of the test?

A82%

B86%

C98%

D90%

E84%

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