If the cutoff value of a diagnostic test is raised, what effect will this have on false negatives?

Raising the cutoff value of a diagnostic test directly impacts the number of false negatives. In diagnostic testing, a cutoff value is the threshold at which a test result is considered positive or negative. When the cutoff is elevated, fewer results will be classified as positive because only the tests that show a stronger signal—those above the new, higher threshold—will be deemed positive.

As a result of this adjustment in the cutoff value, some individuals who actually have the condition may now fall below the new threshold and receive a negative result, even though they are truly positive for the disease. This situation increases the number of false negatives, where the test inaccurately indicates that a disease is not present when, in fact, it is.

This understanding highlights the trade-off that occurs in diagnostic testing. While increasing the cutoff may reduce the number of false positives (incorrectly identifying healthy individuals as sick), it simultaneously raises the risk of false negatives, which can have serious implications for patient care and management. In clinical practice, it's critical to choose cutoff values that balance the sensitivity (the ability to correctly identify those with the disease) and specificity (the ability to correctly identify those without the disease) according to the specific scenario and the consequences of missed diagnoses.