How to determine sensitivity11/29/2022 ![]() Thus the exercise test has higher sensitivity in individuals with triple-vessel disease than in those with single-vessel disease. If the population is skewed toward individuals with a greater severity of disease, the test will have higher sensitivity. Once a discriminant value that determines a test's specificity and sensitivity is chosen, the population tested must be considered. 26 The standard exercise test cut point of 0.1 mV (1 mm) of horizontal or downsloping ST-segment depression in three consecutive beats of at least a single lead has been selected as the discriminating cut point and has a sensitivity of 68% and specificity of 77%. These can be selected by specifying a discriminant or diagnostic cut point. All tests have a range of inversely related sensitivities and specificities such that when sensitivity is the highest, specificity is lowest, and vice versa. Specificity is the percentage of those without disease who have normal test results, and it may be affected by resting ECG patterns (e.g., LV hypertrophy, ST-T abnormalities, interventricular conduction delay) and drugs such as digoxin. Sensitivity is the percentage of individuals with a disease who have abnormal test results and, in the case of CAD, is influenced by disease severity, effort level, and the use of anti-ischemic drugs. Sensitivity and specificity define how effectively a test discriminates individuals with disease from those without disease. ![]() Table 13.10 outlines the diagnostic characteristics of stress testing. Zipes MD, in Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 2019 Sensitivity and Specificity ![]()
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