Youden Index Calculator

Evaluate diagnostic test performance with the Youden J statistic

Input Method

Confusion Matrix Values

Confusion Matrix

Actual Positive
Actual Negative
Pred. Positive
True Positive
20
False Positive
5
Pred. Negative
False Negative
15
True Negative
40

Correctly identified positive cases

Incorrectly identified as positive

Incorrectly identified as negative

Correctly identified negative cases

Youden Index Results

0.4603
Youden Index (J)
57.14%
Sensitivity
88.89%
Specificity
Fair
Performance
75.00%
Accuracy
43.75%
Prevalence
80.00%
PPV
72.73%
NPV

Interpretation

Fair test performance. The test shows moderate diagnostic value but may benefit from optimization or combination with other tests.

Youden Index Range: 0 (no diagnostic value) to 1 (perfect test)
Current Value: 0.4603 indicates fair diagnostic performance

Example: COVID-19 Test

Confusion Matrix

True Positive: 85 (correctly identified infected)

False Positive: 10 (false alarms)

False Negative: 15 (missed cases)

True Negative: 90 (correctly identified healthy)

Calculations

Sensitivity: 85/(85+15) = 0.85

Specificity: 90/(90+10) = 0.90

Youden Index: 0.85 + 0.90 - 1 = 0.75

Result

J = 0.75: Good diagnostic performance with excellent balance between sensitivity and specificity.

Performance Interpretation

J ≥ 0.8: Excellent

Outstanding test with high accuracy

+

J ≥ 0.6: Good

Strong diagnostic performance

~

J ≥ 0.4: Fair

Moderate diagnostic value

!

J ≤ 0: No Value

No better than random chance

Key Applications

Medical Diagnostics: Evaluating clinical tests and screening procedures

Biomarker Research: Assessing diagnostic biomarker performance

Cut-off Optimization: Finding optimal threshold values

Test Comparison: Comparing multiple diagnostic methods

Understanding the Youden Index

What is the Youden Index?

The Youden Index (J statistic) is a single statistic that captures the performance of a dichotomous diagnostic test. It represents the test's ability to avoid failure, combining both sensitivity and specificity into one measure.

Key Advantages

  • Single Metric: Combines sensitivity and specificity
  • Threshold Independent: Useful for cut-off optimization
  • Easy Interpretation: Range from 0 to 1

Formula & Calculation

Youden Index Formula

J = Sensitivity + Specificity - 1

Also expressed as: J = TPR + TNR - 1

Component Formulas

Sensitivity = TP / (TP + FN)

Specificity = TN / (TN + FP)

Alternative Expression

J = TPR - FPR

True Positive Rate minus False Positive Rate

Step-by-Step Calculation

  1. 1.Obtain or calculate sensitivity (true positive rate)
  2. 2.Obtain or calculate specificity (true negative rate)
  3. 3.Apply the Youden formula: J = Sensitivity + Specificity - 1
  4. 4.Interpret the result using performance categories

Clinical Applications

  • Screening Tests: Cancer screening, disease detection
  • Biomarker Validation: Evaluating diagnostic markers
  • Test Optimization: Finding optimal cut-off points
  • ROC Analysis: Identifying best performance point