title: Diagnostic tests: distinguishing good tests from bad and even ugly ones.
abstract: This article focuses on the selection and interpretation of diagnostic tests, emphasizing the importance of understanding how their mathematical parameters affect the information they provide in various settings. The utility and limitations of sensitivity, specificity, predictive value, and receiver operating characteristic (ROC) curves are discussed using catheter-related bloodstream infections as an example. ROC curves have been used for selecting optimal cutoff values for a positive result and for selecting among several alternative diagnostic tests. For example, 16 different tests have been proposed for diagnosis of catheter-related bloodstream infection; ROC analysis provides an effective way to determine which test offers the best overall performance.
authors.affiliation: University of Virginia Health System, Charlottesville 22908-0473, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Farr
authors.forename: D E
authors.initials: DE
authors.lastname: Shapiro
mesh_terms: D002404:Catheterization / Q000009:adverse effects; D003428:Cross Infection / Q000175:diagnosis*; D003937:Diagnosis, Differential; D017743:Equipment Reuse; D006801:Humans; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis*