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The table below displays data taken from a study comparing self-reported smoking status with measured serum cotinine level. As part of the study, cotinine level

  1. The table below displays data taken from a study comparing self-reported smoking status with measured serum cotinine level. As part of the study, cotinine level was used as a diagnostic tool for predicting smoking status; the self-reported status was considered to be true. For a number of different cutoff points, the observed sensitivities and specificities are given below.

Cotinine Level (ng/ml)

Sensitivity

Specificity

5

0.971

0.898

7

0.964

0.931

9

0.960

0.946

11

0.954

0.951

13

0.950

0.954

14

0.949

0.956

15

0.945

0.960

17

0.939

0.963

19

0.932

0.965

  1. As the cutoff point is raised, how does the probability of a false positive result change? How does the probability of a false negative result change?
  2. Use these data to construct a receiver operator characteristic curve.
  3. Based on this graph, what value of serum cotinine level would you choose as an optimal cutoff point for predicting smoking status? Why?

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