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Episode Notes

USMLE purpose: Work backward from sensitivity, specificity, and prevalence to build a 2×2 diagnostic table.

How to use this page

  1. If no sample size is given, choose an easy number like 1000.
  2. Use prevalence to split disease+ vs disease−.
  3. Use sensitivity to fill the disease+ column.
  4. Use specificity to fill the disease− column.
  5. Calculate PPV or NPV from the completed table.
Episode metadata
FieldDetails
EpisodeRandy Neil Biostats 20
TopicViewer requested biostats review
Runtime13 min
Published2022-03-05
SourceOpen YouTube video

One-liner

When prevalence is given but sample size is missing, choose N = 1000 , build the diagnostic table, then calculate PPV.

Worked PPV setup

Example: sensitivity 95%, specificity 80%, prevalence 20%, N = 1000.

Disease +Disease -
Test +190160
Test -10640
Total200800

PPV = 190 / (190 + 160) = 190 / 350 ≈ 54%

Board Exam Buzzwords

GivenUse it to fillFormula
PrevalenceDisease+ column totalPrevalence × N
SensitivityTrue positives among disease+TP / disease+
SpecificityTrue negatives among disease−TN / disease−
Positive test actually infected?PPVTP / TP+FP

Anki-style rapid recall

If no N is given, what number can you choose?

Choose 1000 to avoid awkward decimals.

How does prevalence help build the table?

It gives the disease-positive column total.

What does specificity fill?

True negatives among patients without disease.

Practice Question

A test has sensitivity 95%, specificity 80%, and prevalence 20%. If N = 1000, what is the PPV?

  • A) 23%
  • B) 54%
  • C) 80%
  • D) 95%
Reveal answer & explanation

Answer: B) 54%

Disease+ = 200, disease− = 800. TP = 190, FP = 160. PPV = 190 / 350 ≈ 54%.