“Gold standard” Sensitivity and specificity of BHB test when compared with each gold standard   Blood strips* Milk strips† Milk meter Foss‡ Stripped milk Foss§ Blood strips N/A Se 29%, Sp 95% Se 19%, Sp 95% Se 24%, Sp 90% Milk strips Se 44%, Sp 91% N/A Se 21%, Sp 94% Se 62%, Sp 92% Milk meter Foss Se 34%, Sp 89% Se 24%, Sp 93% N/A Se 20%, Sp 89% Stripped milk Foss Se 24%, Sp 90% Se 39%, Sp 97% Se 13%, Sp 93% N/A * Blood test strips tested in Precision XTRA® meter † Keto-Test® milk test strips ‡ DHIA milk meter collected samples tested with Fossomatic® milk analyzer § Hand stripped milk samples tested with Fossomatic® milk analyzer

Table 1: Sensitivity and specificity of beta-hydroxybutyrate test methods when each test is used as the “gold standard” in comparison with the others.