A modified ROC analysis for the selection of cut-off values and the definition of intermediate results of serodiagnostic tests

Greiner, Matthias; Sohr, Dorit; Göbel, Petra

doi:10.1016/0022-1759(95)00121-p

Cited by 294 publications

(230 citation statements)

References 15 publications

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“…The selected conditions were used to evaluate the IgG reactivity of sera samples from patients with other relevant infectious-parasitic diseases (Figure 3). The data were further analyzed with the two-graph receiver operating characteristic (TG-ROC) using the CMDT software package 19 . This method reads valid pairs of sensitivity and specificity considering pre-assigned cutoff values and allows the selection of the best condition for data interpretations.…”

Section: Data Interpretation and Statistical Analysismentioning

confidence: 99%

“…In the first approach, valid pairs of sensitivity and specificity were read for pre-assigned cutoff values directly from the TG-ROC plots 19 . The TG-ROC analysis showed that the in-house ELISA used to detect total IgG reactivity did not present any intermediate range (IR) that can be considered a borderline range for the clinical interpretation of test results, therefore indicating that the method displayed 100% valid data with no incorrect results.…”

Section: Discrimination Between Trypanosoma Cruzi Infection and Othermentioning

confidence: 99%

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In-house ELISA method to analyze anti-Trypanosoma cruzi IgG reactivity for differential diagnosis and evaluation of Chagas disease morbidity

Santos

Torres

Machado-de-Assis

et al. 2012

Rev. Soc. Bras. Med. Trop.

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INTRODUCTION: The goal was to develop an in-house serological method with high specificity and sensitivity for diagnosis and monitoring of Chagas disease morbidity. METHODS: With this purpose, the reactivities of anti-T. cruzi IgG and subclasses were tested in successive serum dilutions of patients from Berilo municipality, Jequitinhonha Valley, Minas Gerais, Brazil. The performance of the in-house ELISA was also evaluated in samples from other relevant infectious diseases, including HIV, hepatitis C (HCV), syphilis (SYP), visceral leishmaniasis (VL), and American tegumentary leishmaniasis (ATL), and noninfected controls (NI). Further analysis was performed to evaluate the applicability of this in-house methodology for monitoring Chagas disease morbidity into three groups of patients: indeterminate (IND), cardiac (CARD), and digestive/mixed (DIG/Mix), based on their clinical status. RESULTS: The analysis of total IgG reactivity at serum dilution 1:40 was an excellent approach to Chagas disease diagnosis (100% sensitivity and specificity). The analysis of IgG subclasses showed cross-reactivity, mainly with NI, VL, and ATL, at all selected serum dilutions. Based on the data analysis, the IND group displayed higher IgG3 levels and the DIG/Mix group presented higher levels of total IgG as compared with the IND and CARD groups. CONCLUSIONS: These findings demonstrated that methodology presents promising applicability in the analysis of anti-T. cruzi IgG reactivity for the differential diagnosis and evaluation of Chagas disease morbidity.

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Section: Data Interpretation and Statistical Analysismentioning

confidence: 99%

Section: Discrimination Between Trypanosoma Cruzi Infection and Othermentioning

confidence: 99%

In-house ELISA method to analyze anti-Trypanosoma cruzi IgG reactivity for differential diagnosis and evaluation of Chagas disease morbidity

Santos

Torres

Machado-de-Assis

et al. 2012

Rev. Soc. Bras. Med. Trop.

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“…The cutoff value (CV) for the FAS score was created with 3 methods: 1) the Youden Index (YI) [13] [14], which evaluates the value for which "sensitivity -(1 -specificity)" is the highest; 2) a method that evaluates the shortest distance from the coordinates (false-positive ratio, sensitivity) = (0, 1) to the ROC curve (the Minimum Distance method [MD]) [15]; and 3) the Two-Graph ROC method (TG) [16], which determines the value that is at the intersection of the FAS score-sensitivity curve and the FAS score-specificity curve.…”

Section: Methodsmentioning

confidence: 99%

Fitness Age Score and the Risk of Long-Term Care Insurance Certification—The Kyoto-Kameoka Longitudinal Study

Yoshida¹,

Kimura²,

Yamada³

et al. 2017

OJEpi

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Long-Term Care Insurance System has been introduced to provide appropriate care for the elderly who needs nursing care in Japan. Physical function is one of most important function for the elderly to live independently. A previous study had established a Fitness Age Score (FAS) based on a theory for biomarker of aging. This study clarified whether the FAS could be used to predict the need for certification of long-term care (CLTC) in independent elderly people. We included 939 independent, community-dwelling-elderly (average age, 74.4 years) whose physical function was measured and for whom the CLTC was tracked for 24 months. The FAS comprised five physical fitness items: Walking time, grip strength, one-leg standing, vertical jump, and functional reach test. Based on the FAS, we calculated the odds ratio (OR) for the CLTC. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) was used for further analysis. We also used the Youden Index (YI), minimum distance method (MD), and two-graph ROC method (TG) to calculate cutoff values (CVs) for screening. We divided subjects into the low and high physical fitness group with CVs. We developed cumulative CLTC curves using the Kaplan-Meier method. Sixteen people could not be tracked for the full 24 months. The measurement of FAS was completed for 798 people, of whom 28 became CLTC. The measurement of FAS was not completed for 125 people, of whom 21 became CLTC. The CLTC OR for people 191with incomplete FAS was 5.553. The AUC was 0.72 (p < 0.001). The CVs for the FAS were −0.29 for YI (sensitivity, 92.9% and specificity, 40.4%), −1.23 for MD (57.1% and 73.4%), and −0.81 for TG (60.7% and 60.9%). The cumulative CLTC curves according to CVs all showed significant differences (p = 0.000 -0.020). In conclusion, the FAS can be used to predict CLTC.

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“…The cut-off value was established to achieve a minimum of 99% specificity [14]. Diagnostic accuracy was further evaluated with the aid of the receiver operating characteristic (ROC) curve analysis in StatsDirect version 2.7.8 software.…”

Section: Brucellin Skin Testmentioning

confidence: 99%

Evaluating the Brucellin Skin Test as an Additional Test to Control Bovine Brucellosis

Nyanhongo¹

2017

SOJMID

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Brucellosis is a bacterial disease of high veterinary importance, besides being a significant zoonosis worldwide. It is characterised by variable, and at times long and latent, incubation periods, which makes its control and eradication a challenging effort. No single test is able to identify all stages of the disease with high sensitivity. The brucellin skin test, which has been proved to identify some acute and chronic latent stages of brucellosis, has not been validated in South Africa. The objective of this study was to evaluate the brucellin skin test in brucellosis free, as well as confirmed infected cattle herds, under South African commercial farming conditions. The results indicate that the brucellin skin test has a high specificity (99.2% (95% confidence interval (CI): 98.1% -99.7%)), and that despite a relatively low sensitivity (42.9 % (95% CI: 30.5% -56.0%)), it was able to identify all the infected herds and detect more infected heifers in infected herds when compared to the routinely used Rose Bengal Test and Complement Fixation Test. It was concluded that the brucellin skin test could be used in parallel with serological tests to improve the sensitivity of the current diagnostic strategy in chronically infected herds where eradication of the disease has proven problematic. Removal of more infected heifers would decrease infection pressure and streamline vaccination towards heifers not exposed to Brucella abortus.

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A modified ROC analysis for the selection of cut-off values and the definition of intermediate results of serodiagnostic tests

Cited by 294 publications

References 15 publications

In-house ELISA method to analyze anti-Trypanosoma cruzi IgG reactivity for differential diagnosis and evaluation of Chagas disease morbidity

In-house ELISA method to analyze anti-Trypanosoma cruzi IgG reactivity for differential diagnosis and evaluation of Chagas disease morbidity

Fitness Age Score and the Risk of Long-Term Care Insurance Certification—The Kyoto-Kameoka Longitudinal Study

Evaluating the Brucellin Skin Test as an Additional Test to Control Bovine Brucellosis

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