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ROC curve — FRCA Primary MCQ

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HardStatisticsROC curveFRCA Primary

Two pre-operative risk scores both have an area under the ROC curve of 0.82. At the clinically required sensitivity of 0.95, score X has specificity 0.40 and score Y has specificity 0.70. What follows?

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Correct answer: D — Score Y gives fewer false positives at the required sensitivity

The best answer is “Score Y gives fewer false positives at the required sensitivity”. Equal overall AUC does not mean equal performance at a clinically selected operating point. At the same sensitivity of 0.95, specificity 0.70 gives fewer false positives than specificity 0.40. Predictive value still depends on prevalence, and neither the AUC nor an arbitrary 0.90 threshold determines clinical usefulness alone.

Reference: Corbacioglu and Aksel, ROC curve analysis in diagnostic accuracy studies: https://pmc.ncbi.nlm.nih.gov/articles/PMC10664195/