Understanding Test Sensitivity and Misunderstanding Test Specificity
Justin R.C. Abe, B.S1*, Tyler J. Liu, B.S1, Loren G. Yamamoto, MD, MPH, MBA2
1Medical Student at the University of Hawai`i John A. Burns School of Medicine, Honolulu, HI, USA.
2Professor of Pediatrics, University of Hawai`i John A. Burns School of Medicine, Honolulu, HI, USA.
*Corresponding Author: Justin Abe, Medical Student at the University of Hawai`i John A. Burns School of Medicine, Honolulu, HI, USA.
DOI: https://doi.org/10.58624/SVOAMR.2026.04.005
Received: January 29, 2026
Published: February 23, 2026
Citation: Abe JRC, Liu TJ, Yamamoto LG. Understanding Test Sensitivity and Misunderstanding Test Specificity. SVOA Medical Research 2026, 4:1, 25-31. doi: 10.58624/SVOAMR.2026.04.005
Abstract
Background: Clinicians often assess test results by referencing sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). However, these concepts are frequently misinterpreted.
Objective: This study aimed to assess understanding of test sensitivity and specificity among physicians and medical trainees.
Methods: Questions were developed with the intention of testing participants on sensitivity and specificity in various ways: 1) a strict definition, 2) examples using numbers, and 3) within a clinical context. A survey containing these questions was distributed to medical students, residents, and physicians in 2023.
Results: 171 participants responded to the survey, which consisted of 83 trainees and 88 non-trainees. Since subjects who were contacted for the study were encouraged to share the study with other eligible participants that they knew, a response rate could not be obtained. Overall, participants performed better on questions that asked about sensitivity. 49% of participants correctly defined sensitivity, while 36% correctly defined specificity. The largest discrepancy was observed when participants were asked to define sensitivity and specificity within a clinical context: 63% answered correctly regarding sensitivity, as compared to 32% for specificity. When asked about specificity, the incorrect answer choices with the most participant responses referred to the positive predictive value.
Conclusion: Within this group of participants, understanding of sensitivity is moderate and understanding of specificity is poor. While this may be due to poor training or lack of clinical experience, we suspect it could also be due to inconsistencies in the English and epidemiological definitions of specificity.
Keywords: Screening Test; Sensitivity; Specificity; Positive Predictive Value; Negative Predictive Value