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* Help needed with NBME 5 Question
 #863982  
  step3_2013 - 12/26/20 13:53
 
  A 68-year-old African American man with no significant past medical history comes to the office for evaluation of low back
pain that started 4 months ago. He is concerned that he might have cancer because his uncle died of bone cancer. There
are no relief of the patientís pain with ibuprofen, aspirin or naproxen taken successively during 4 weeks at recommended
therapeutic doses for over-the-counter use, although he did get moderate relief with 1 week of bed rest. He has
otherwise been healthy and is pleased that he has lost 4.5 kg (10lb) in the past 6 months by not eating between meals. His
height is 188 cm (6 ft 2 in) and his weight is 82 kg (180 lb); BMI is 24 kg/m^2.
Medical History

sensitivity Specificity
Age > 50 years 0.77 0.07
Previous history of cancer 0.31 0.98
Unexplained weight loss 0.15 0.94
Failure of 1 month of anti-inflammatory medication 0.31 0.90
No relief with bed rest 0.90 0.46
Duration of pain > 1 month 0.50 0.81

The medical history that is most suggestive of cancer as a cause of this patientís back pain is which of the following?
A. Age
B. Failure to improve with medication
C. 4-month duration of pain
D. Relief with bedrest
E. Weight loss

Why is the answer B? Are we going off of specificity instead of sensitivity? If we're screening for a disease, shouldn't sensitivity be the measure?
 
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* Re:Help needed with NBME 5 Question
#3391767
  malena - 12/27/20 13:26
 
  Because its cancer bone pain which doesn't respond to pain medication . This is not about Biostar sensitivity or specificity  
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