The utility of the test decreases with reduced risk. A 99% specific test is good when there are high levels of disease going around (e.g. covid in a hospital).

The utility of the test decreases with reduced risk. A 99% specific test is good when there are high levels of disease going around (e.g. covid in a hospital). In the community, rates are much lower, so the positive predictive value of the test is much lower, even with 99% specificity. My conclusion is that if you tried this in a community setting, the number of false positives would far outweigh the true positives, and lead to dismissal of alerts.