The algorithms are optimized for sensitivity and negative predictive value (NPV) because these metrics are crucial for an effective screening test. High sensitivity ensures that no positive patients are missed, while high NPV guarantees that if someone is declared negative, they indeed are negative. The lower positive predictive value (PPV) is a result of prioritizing these factors and represents the appropriate trade-off.
Second point: PPV is influenced by specificity. The specificity of these algorithms surpasses that of current screening tools, such as questionnaires. Therefore, although a 35% PPV might seem low, it is actually better than what existing tools offer.
The key takeaway is that, as a screening tool, sensitivity and NPV are what matter most.
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