Dr Neil Paul

Sensitivity and Specificity

· Originally posted on LinkedIn, Aug 2020

From my LinkedIn Post

For the less scientific it might be worth revisiting the concepts of sensitivity and specificity.

The ideal test should be 100% accurate, it should be specific ie never say you have a disease when you don’t (low false positives) and sensitive ie never say you don’t have a disease when you do (low false negatives)

Now very few medical tests meet this 100% goal. The classic example that people might be familiar with is the urine pregnancy test – if it says you are pregnant you almost certainly are pregnant, but if it says you aren’t, there is a chance you are so check again..

Now Covid testing is interesting as although the experts say the lab bit of the test is almost 100% there is a huge human factor involved in the test especially in self testing or through a car window. If you don’t insert the swab far enough in or get enough of a sample the false negative rate can apparently be high.

What does this mean & what is the implication? Well it means if it says you have covid – you almost certainly do.. but if it says you don’t, well you might still have it.. especially if you have classic symptoms – temp and cough..

So my advice is don’t rely on a negative test to assume you are safe to go back to work or see vulnerable relatives, which is what some of my patients are doing.

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