WBR0147

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Author [[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Biostatistics/ Epidemiology
Sub Category SubCategory::Endocrine
Prompt [[Prompt::Two medical teams from France and Russia are conducting a similar study that aims to detect an association between vitamin K deficiency and osteoporosis. Both teams are using the same test kit that is designed to measure vitamin K level in the blood. While the sensitivity of the test is 90%, its specificity is found to be 85%. According to previous studies, the prevalence of vitamin K deficiency is higher in Russia than it is in France.

Based on the previous information, which of the following statements is correct?]]

Answer A [[AnswerA::The ability of the test to detect vitamin K deficiency in people who really have a low vitamin K level is higher in Russia that it is in France.]]
Answer A Explanation [[AnswerAExp::The ability of the test to detect vitamin K deficiency in people who really have a low vitamin K level refers to the sensitivity of the test. The sensitivity of the test was mentioned to be 90% and this value is constant for a particular test. The sensitivity of this test is independent from the prevalence of vitamin K deficiency.]]
Answer B AnswerB::The positive predictive value of the test is the same in France and Russia.
Answer B Explanation [[AnswerBExp::The positive predictive value (PPV) is used to indicate the probability that in case of a positive test, the patient really has the specified disease. PPV is a function of the population sampled whereby a higher yield occurs in a higher risk group. The PPV depends on the sensitivity, specificity and prevalence of the tested item. Since the prevalence of vitamin K deficiency is different in Russia than it is in France, then the PPV is not the same in these two different countries.]]
Answer C AnswerC::The positive predictive value of the test is higher in Russia that it is in France.
Answer C Explanation [[AnswerCExp::The positive predictive value (PPV) is used to indicate the probability that in case of a positive test, that the patient really has the specified disease. PPV is a function of the population sampled whereby a higher yield occurs in a higher risk group. The PPV depends on the sensitivity, specificity and prevalence of the tested item. Since the prevalence of vitamin K deficiency is higher in Russia than it is in France, then the PPV of this test is higher in Russia than it is in France.]]
Answer D AnswerD::If the test is positive, the probability that the person truly has vitamin K deficiency is higher in France than it is in Russia.
Answer D Explanation [[AnswerDExp::The PPV depends on the sensitivity, specificity and prevalence of the tested item. Since the prevalence of vitamin K deficiency is lower in France than it is in Russia, then the PPV of this test is lower in France than it is in Russia.]]
Answer E AnswerE::The positive predictive value of the test does not depend on the sensitivity and specificity.
Answer E Explanation [[AnswerEExp::The PPV depends on the sensitivity, specificity and prevalence of the tested item.]]
Right Answer RightAnswer::B
Explanation [[Explanation::The positive predictive value (PPV) is used to indicate the probability that in case of a positive test, the patient really has the specified disease. PPV is a function of the population sampled whereby a higher yield occurs in a higher risk group.

Educational objective: The PPV depends on the sensitivity, specificity and prevalence of the tested item.
Educational Objective:
References: ]]

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