Sensitivity and specificity should never be interpreted in isolation without consideration of other clinical utility metrics.

OBJECTIVE: The purpose of this paper is to highlight the risks and pitfalls of interpreting sensitivity and specificity in isolation when evaluating the clinical utility of a new test/measure to predict a target behavior, disease, or condition.

METHOD: This paper (a) provides a primer for a set of metrics that can be used to appropriately examine the clinical utility of a test/measure (i.e. test operating characteristics - TOC), and (b) provides a discussion regarding various interpretative considerations when using TOCs that supports the tenet of this paper.

CONCLUSIONS: There are two primary conclusions. First, sensitivity and specificity should never be interpreted in isolation as a means for evaluating the clinical utility of a test/measure. When sensitivity and specificity are used in this manner, more often than not, this will result in erroneous and/or incomplete conclusions regarding the clinical utility of a new test/measure. Second, sensitivity and specificity values are important, but they must be interpreted in conjunction with other more relevant clinical utility metrics (e.g. positive predictive power and negative predictive power).