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15 February 1994 | Volume 120 Issue 4 | Page 345
When discussing the new diagnostic tests for sexually transmitted Chlamydia trachomatis infection, Stamm [1] writes that "Although none of these tests is as sensitive or specific as high-quality cultures for chlamydia, all have reasonable sensitivity (70% to 90%) and specificity (96% to 99%) in groups where the prevalence of chlamydial infection exceeds 8% to 10%." Sensitivity is defined as the percentage of diseased patients who are correctly identified as positive by a test. Specificity is the percentage of disease-free patients who are correctly identified as negative [2]. These test characteristics are not affected by the prevalence of disease. The author must have been referring instead to the predictive value of a positive test result and the predictive value of a negative test result, both of which vary according to the prevalence of disease in the population in which the test is applied.
1. Stamm WE. Toward control of sexually transmitted chlamydial infections (Editorial). Ann Intern Med. 1993; 119:432-4.
2. Mausner JS, Kramer S. Epidemiology—an introductory text. 2nd ed. Philadelphia: W.B. Saunders Company; 1985:217-23. About Letters
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Sensitivity, Specificity, Prevalence, and Disease Stage
TO THE EDITOR:
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College of Physicians and Surgeons, Columbia University; New York, NY 10032
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