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Table 1 Subgroup analysis of the sensitivity, specificity and likelihood ratios of the Papanicolaou smear test

From: A methodological framework to distinguish spectrum effects from spectrum biases and to assess diagnostic and screening test accuracy for patient populations: Application to the Papanicolaou cervical cancer smear test

    Clinical reading (n = 1781) Optimized interpretation (n = 1777)
Variables† n
(%)
Disease prevalence n (%) Sensitivity % Specificity % Positive likelihood ratio Negative likelihood ratio Sensitivity % Specificity % Positive likelihood ratio Negative likelihood ratio
HPV test           
   Positive 537 (30) 282 (53) 95 76 4.02 0.07 92 76 3.93 0.10
   Negative 1244 (70) 73 (6) 64 93 9.31 0.38 64 93 8.85 0.38
Study setting           
   Screening 1320 (74) 70 (5) 70 94 12.32 0.32 75 92 8.96 0.27
   Referral clinic 461 (26) 285 (62) 93 60 2.34 0.12 89 77 3.90 0.14
Age           
   <35 years 981 (55) 158 (16) 89 92 11.66 0.12 83 91 9.44 0.19
   ≥ 35 years 800 (45) 197 (25) 88 87 6.79 0.14 89 88 7.37 0.12
Current smoking           
   Yes 602 (34) 161 (27) 90 88 7.22 0.11 87 89 7.67 0.15
   No 1161 (66) 188 (16) 87 91 9.98 0.14 87 90 8.94 0.15
European origin           
   Yes 1623 (91) 312 (19) 88 91 9.71 0.13 87 90 8.81 0.15
   No 158 (9) 43 (27) 91 81 4.74 0.11 83 86 5.99 0.19
Educational level           
   < Higher 1063 (60) 227 (21) 88 87 7.15 0.14 87 88 7.31 0.15
   ≥ Higher 709 (40) 128 (18) 89 93 14.38 0.12 86 92 11.06 0.15
Postmenopausal           
   Yes 174 (10) 44 (25) 86 88 7.49 0.15 93 91 10.09 0.08
   No 1607 (90) 311 (19) 89 90 9.13 0.12 85 90 8.31 0.16
Contraception           
   None 640 (36) 127 (20) 89 89 8.30 0.12 87 90 8.93 0.14
   Combined oral pill 905 (51) 173 (19) 87 91 9.26 0.14 83 90 8.50 0.19
   Others 236 (13) 55 (23) 91 91 9.68 0.10 96 87 7.27 0.04
  1. † Data were missing for the following variables: current smoking (18 patients) and educational level (9 patients).
  2. Significant comparisons are indicated in bold.