Peter Attia· MD
if you drive something to a very very very high sensitivity the specificity must go down and here's the silly example and this is his example so i don't want to take any credit for it but it's brilliant if you wrote a letter max to a thousand women randomly and told every one of them they had breast cancer with no additional knowledge you technically have a test with a hundred percent sensitivity because let's assume i don't know 10 let's assume 50 of those women have breast cancer you have correctly identified them all there are no false negatives in that group so you have a 100 sensitive test the problem is your specificity is in the toilet you have so many false positives that the test is utterly useless so you can have 100 sensitivity if you really want to push that envelope but it it has no clinical utility