The proposed example on CRLF2 expression in acute lymphoblastic leukemia [ 10] shows that in some clinical applications methods based on sensitivity and specificity may lead to unsatisfactory cut-points due to a moderate discrimination potential of the biomarker, as represented by the whole ROC curve.
In a humorous "short autobiography" of his drinking life that F Scott Fitzgerald wrote for the New Yorker, he remembered the year 1927 as one of "delicious California 'Burgundy-type' wine … The beer I made … Cases of dim, cut, unsatisfactory whiskey …" In prohibition America, this was the best that one could hope for.
But there are not a lot of choices: cut down on delivery (unsatisfactory), build roads (politically complex and expensive), or go congestion pricing and help some and alienate others.
In such situations, the best test developers can do to ensure reliability is to strictly adhere to detailed test specifications and/or resort to unsatisfactory ad hoc measures such as adjusting cut-off scores so as to ensure the percentage of test takers who pass remains constant (McNamara [1996]).
In fact, this last method showed an unsatisfactory performance when oriented to identify a cut-point in the presence of a binary outcome [ 5].
Khan's last fight was a technical decision over Paul McCloskey in Manchester in April, which ended in unsatisfactory circumstances when the Northern Irish challenger suffered a cut eye.
Three children (all with bilateral clubfoot) had unsatisfactory overall foot status according to the total CAP cut-off points, with a median of 55 (55.7-55.3).
A difficult issue is how to decide cut-off points which distinguish meaningfully between clearly satisfying and unsatisfactory parenting.
6 7 An attempt to estimate the sensitivity based on a meta-analysis was unsatisfactory because of the merging of studies with different probe sites, different cut-off values for saturation, and different oximeters measuring either functional or fractional saturation.
Consequently, if operational conditions change or if the priori conditions remain unchanged but the cut-off diameter must be decreased, the separator will probably display unsatisfactory performance, and a new design may be necessary.
