What could happen to the accuracy of the carotid test if the peak systolic velocity value needed for a positive result is increased?

When the peak systolic velocity value required for a positive carotid test result is increased, the impact on the accuracy of the test is not straightforward and can vary based on factors such as the patient population and specific clinical context.

By raising the threshold for what constitutes a "positive" finding, there is potential for both an increase in the false negative rate (where significant stenosis may not be detected) and a decrease in the false positive rate (where non-significant issues may be incorrectly flagged as serious problems).

This means that while some cases of significant stenosis might be missed (leading to a decrease in accuracy), at the same time, there could be fewer instances of benign conditions being identified as dangerous (improving accuracy in that respect). Therefore, the overall accuracy is not guaranteed to rise or fall but rather may vary depending on the specific scenarios encountered during testing. This dual effect exemplifies why the accuracy may increase or decrease with the adjustment of the peak systolic velocity criterion.

In contrast, indicating that accuracy will inevitably decrease suggests a lack of nuance in understanding test metrics. Similarly, the notion that accuracy will remain entirely stable fails to recognize the dynamic nature of diagnostic thresholds, and claiming that accuracy will only increase by a significant margin disreg