McNemar's test

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McNemar's test is a statistical test used on paired nominal data. It is applied to 2 × 2 contingency tables with a dichotomous trait, with matched pairs of subjects, to determine whether the row and column marginal frequencies are equal (that is, whether there is "marginal homogeneity"). It is named after Quinn McNemar, who introduced it in 1947.^[1] An application of the test in genetics is the transmission disequilibrium test for detecting linkage disequilibrium.^[2]

The commonly used parameters to assess a diagnostic test in medical sciences are sensitivity and specificity. Sensitivity (or recall) is the ability of a test to correctly identify the people with disease. Specificity is the ability of the test to correctly identify those without the disease.

Now presume two tests are performed on the same group of patients. And also presume that these tests have identical sensitivity and specificity. In this situation one is carried away by these findings and presume that both the tests are equivalent. However this may not be the case. For this we have to study the patients with disease and patients without disease (by a reference test). We also have to find out where these two tests disagree with each other. This is precisely the basis of McNemar's test. This test compares the sensitivity and specificity of two diagnostic tests on the same group of patients.^[3]