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. 2021 Feb 25;36(2):179–196. doi: 10.1007/s10654-021-00727-7

Fig. 3.

Fig. 3

The relative importance of test sensitivity and specificity depends on the underlying seroprevalence in the study population. The value of a test can be described through the positive predictive value (PPV), which is defined as the probability that an individual truly has been infected with the virus given that they test positive and is calculated as the number of true positives divided by the total number of positive tests. Similarly, the negative predictive value (NPV) is defined as the probability that an individual truly has not been infected with the virus given that they test negative and is calculated as the number of true negatives divided by the total number of negative tests. When the underlying seroprevalence is low, test performance is largely a function of specificity, as the majority of individuals in the population have not been infected, while sensitivity is more important as seroprevalence increases. Note that the negative predictive values for the baseline and low specificity tests are very similar so the curves nearly overlap in the figure