Estimation of Test Sensitivity and Specificity When Disease Confirmation Is Limited to Positive Results

Estimation of sensitivity and specificity for diagnostic or screening tests usually requires independent confirmation of subjects as diseased or nondiseased using a gold standard. In practice, however, application of the confirmatory procedure is usually limited to individuals with one or more positive test results. For situations in which two initial tests are applied, recent literature has shown that one can use the data from confirmed …