This video is designed to accompany
pages 81-94
in
Making Sense of UncertaintyActivities for Teaching Statistical
ReasoningVan-Griner Publishing Company
ImPACT Example
Concern about concussions in young athletes is at an all-time high. A variety of screening tests are available for assessing concussion status, some are to be used on the field; others take more time. One such test is the “ImPACT” test, which stands for “Immediate Post-Concussion Assessment and Cognitive Testing.”
How well does ImPACT perform as a screening test?
ImPACT Example
Rule: Beyond a certain level on the ImPACT scale you are said to be
concussed.Actual Status
ImPACT Prediction Athlete was, in
reality, not concussed
Athlete was, in reality,
concussed TotalsImPACT said “not
concussed”59 13 72
ImPACT said “concussed”
7 59 66
Totals 66 72 138
“Sensitivity and specificity of the ImPACT Test Battery for concussion in athletes.” Archives of Clinical Neuropsychology, 2005
FPR = 7/66 = 0.11 or 11%FNR = 13/72 = 0.18 or 18%
Specificity = 89%Sensitivity = 82%
Beck Inventory Example
The original BDI, first published in 1961, consisted of twenty-one questions about how the subject has been feeling in the last week. A typical question is below.
Choose the most appropriate response (0) I do not feel sad. (1) I feel sad. (2) I am sad all the time and I can't snap out of it. (3) I am so sad or unhappy that I can't stand it.
How well does Beck perform as a screening test?
Beck Inventory Example
Rule: If your total score on the Beck Inventory is 10 or greater then you
will be categorized as clinically depressed.
Actual Status as determined by
Diagnostic and Statistical Manual of Mental Disorders IV
Beck Inventory Indication
Patient was, in reality, not depressed
Patient was, in reality,
depressed TotalsBeck said “not
depressed”66 5 71
Beck said “depressed”
12 12 24
Totals 78 17 95
“Sensitivity and Specificity of Depression Questionnaires in a College-Age Sample.” Journal of Genetic Psychology, 2008, 169(3), 281–288
FPR = 12/78 = 0.14 or 14%FNR = 5/17 = 0.29 or 29%
Specificity = 85%Sensitivity = 71%
Field Sobriety Testing
There are three common testing procedures implemented during an FST: horizontal gaze nystagmus (HGN), one-leg stand (OLS), and walk and turn (WAT).
Data from 296 subjects who participated in the NHTSA’s 1998 San Diego field sobriety test validation study, ordered by total scores on these three FST procedures, are available .
Let’s set a cutoff for the field rule and assess how well the rule is working as a screening test for intoxication.
Rules
For The Test: assume that a 4 or above on the FST will tag a participant as drunk.
Concerning The Truth: assume that a BAC of 0.04% or greater means a participant is legally drunk. There were 267 study participants with BACs of 0.04% or greater.
Task at Hand
Using Total FST >=4 to Designate “Drunk”
FST Decision
Actual BACTotal
s< 0.04 (Sober)
>= 0.04 (Drunk)
Sober
Drunk
Totals 29 267 296
Fill out this table!
Field Sobriety TestingCase HGN OLS WAT Total FST
Actual BAC
229 0 0 1 1 0254 0 0 1 1 0.0266 1 1 0.067
142 2 0 0 2 0.005217 2 0 0 2 0.03191 2 2 0.034182 2 0 0 2 0.038109 2 2 0.04259 2 0 0 2 0.04199 0 1 1 2 0.048113 2 0 0 2 0.0522 2 2 0.0667 2 1 3 0.022
145 0 3 0 3 0.0353 2 0 1 3 0.03215 2 0 1 3 0.04
287 2 0 1 3 0.0489 2 1 0 3 0.05
123 0 1 2 3 0.05258 2 1 0 3 0.05335 2 0 2 4 011 2 1 1 4 0.01
247 4 4 0.0166 2 0 2 4 0.02
294 2 0 2 4 0.02231 2 0 2 4 0.0374 2 1 1 4 0.04
214 2 1 1 4 0.0458 4 4 0.0514 2 1 1 4 0.05834 4 0 0 4 0.05812 2 0 2 4 0.06
211 2 1 1 4 0.06232 4 0 0 4 0.06293 2 2 0 4 0.06130 2 1 1 4 0.07297 4 4 0.08271 2 0 2 4 0.1119 2 2 4 0.121
Using Total FST >=4 to Designate “Drunk”
FST Decision
Actual BACTotals
< 0.04 >= 0.04
Sober
Drunk
Totals 29 267 296
209 11
276
20 256
FPR = 20/29 or 69%Specificity = 9/29 or 31%
FNR = 11/267 or 4%Sensitivity = 256/267 or 96%
What If?
Change the rule: assume that a 2 or above on the FST will tag a participant as drunk.
Changes that occur: FPR will surely go up and FNR will surely go down.
So the point is: how well a screening test performs is directly related to the cutoff it uses to identify a “positive.”