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NBME 19 Answers

nbme19/Block 1/Question#44 (reveal difficulty score)
Three tests are developed to identify ...
Test 3 followed by test 1 if test 3 is positive πŸ” / πŸ“Ί / 🌳

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submitted by βˆ—medbitch94(45),
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iticAcn uapurrp sstleru rofm vatnaiotrasxe of odblo into eht rism.ed shTi nehenmopon si eud to eth knis rtyhpao and hte giiyarftl fo teh lodob esseslv ni dreeyll usndil,vdiai hiwhc si badeaceetrx by cihnrco usn oxeperu.s cticinA upaurrp leinsso aer codtlea on sdneu-opexs esara, leki teh sar,m e,afc nda enk.c

nkiS rhtoypa in taireoodsromsp si eud ot an aiarteotln of lnoleag,c iamlsri to that hciwh si eens in opistr.ososoe ihTs unpdreocon knsi rtoyahp uedsca yb eht ohongg-atpi mekas eht ldrmea ulcavasr ewotkrn yrve sitveneis to the gltesihts ramtau or nihsager oferc.

submitted by βˆ—cassdawg(1533),
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:RLDT; uYo awnt teh omts vnieeitss sett tisrf to relu uto het easedsi ni ingvsatee (tsael hikdoeloil fo aefls eg)ivtaen adn eht omts icsecfpi tets xnet to lue"r i"n oynl urte poisvesit tale(s olidolihek fo lfeas pvsei)stio [0F20A2 ]725p

ehT ayw I sayalw nhikt fo essviiyittn and eiiypsccfit is ni eintlaro to slfae svngeitea dna esalf ep.stiiosv

  • higH eS N ttyevisi manes yuo aer esls lliyek to eahv laesf eaegisvNt eeomon(s hwo has het sedseai tbu stset aintgee)v
  • giHh s P iteicceyfi nmsea uyo aer ssel kliely ot ahev alsfe tvoiPsies esom(oen owh sttes ovitpesi btu sedo ton ahve het dss)aiee

In sith stquen,io uoy nwta to erseun oyu rae yonl ngetirat tohse how tyaucall ehav het is,eesda or in etohr dwsor ttah uyo natw to imezinim yoru aslef stpiosvie. heT tesb way to do shit si zaixemmi Psyfitecii.c Test 1 has 010% fcspictiiey ainnegm it lwil vhae sielselnyta ON lfaes ivsseopti hhwic is ategr os ew feildnetyi ntaw to esu it lganetinim(i lla tbu two oonts!pi) eTh retteb awy ot eresun yuo ear ihgccatn sa amny sceas sa lepsosbi ilwhe llsit lyon einggtt true vsspitoei is to stte htiw tset 3 fti,rs iwhhc hsa a cumh hihegr s.tisiyentiv Ttah ayw we are nigrlu tou sasdiee in hte vgtneesia fo tste .3 hTsi lsoa sadd ot our yiltbai to ynol rtyul aettr hetos twhi dssaiee sa ew vahe druel uto easeisd ni ruo rfsit gnaveeti poiotlup,an nthe we tste eth istvoipse to ru"el ni" eesadis itwh a ihglyh ccspefii

ehT ussie iwth iugsn tesT 1 trsif and olny gstient the vitsseiop si ew wokn hte pvstisoie ofmr ttes 1 era ykilel ture po,itissev as hte hihygl ecpsific ttse lduwo evah a asiblcyla rezo elsaf iosvtpie ra.te tA htat npoit terhe dwluo be on pntio in gettsin wtih ttes ,3 as ew aveh alasilcyb a tuer isteivop poupl.aniot The sseiu si we ahev sdseim a tol of esdadeis ude ot teh lwo snsyveitiit dan hhgi selaf eivtenag atre fo stte 1.

nhetroA awy to ktnhi fo iths is to ereermmb hte aosmrluf as( evsyittsiNi sanoctni flsea satvgi,eNe dan cftisyiceiP iactnsno sfeal vPsteisoi ni teh lormf;aus see i)sid:tFrA

  • yiistvitsne = eutr piseoivt / eutr( veiopits + lfsae vi)teenag = 1 - aslfe tvgnieea eatr &--;gt hiherg ytinitisves anmse ssle atre of eflas eiavgnest
  • fsctpeyiiic = uert eitegvna / uetr( vgaeeitn + eslaf viops)eti = 1 - afels isvptieo trae ;tg&-- iehhgr fpiitciecys emnas esls arte of lsfae tesiospvi

NSPITU/SON alos pelhs ot ebrremem hatt ifsccpie tsest leur ni e,sisade nad iseietvns estst reul otu sasedei

the_crown_7  Great Explanation. This question tripped me up, with thinking that the best test, would maximize both parameters. So can someone please explain why "Test 2 only" which has the highest sen & spec, is incorrect. +  
shiggins8  Why I didn't choose Test 2 only is because the stem stressed the 'toxicity of the drug,' and thus, treating those who actually have the disease. You would still be treating individuals who may not have the illness, thus exposing them to unnecessary toxicity. Or at least that's how I viewed it. +  

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