A Statistical Method for the Comparison of a Discrete Diagnostic Test with Several Continuous Diagnostic Tests

Ca, Beam; Hs, Wieand

doi:10.2307/2532648

Cited by 23 publications

(9 citation statements)

References 8 publications

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“…This index is a direct extension of a previously proposed statistic [21] to the case of discrete data. Specifically, we use a linear interpolation between the empirical ROC points to generate a continuous ROC curve and use this curve to compute a signed vertical distance (i.e.…”

Section: Methodsmentioning

confidence: 99%

Binary and multi‐category ratings in a laboratory observer performance study: A comparison

et al. 2008

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We investigated radiologists performances during retrospective interpretation of screening mammograms when using a binary decision whether to recall a woman for additional procedures or not and compared it with their receiver operating characteristic (ROC) type performance curves using a semi-continuous rating scale. Under an Institutional Review Board approved protocol nine experienced radiologists independently rated an enriched set of 155 examinations that they had not personally read in the clinic, mixed with other enriched sets of examinations that they had individually read in the clinic, using both a screening BI-RADS rating scale (recall/not recall) and a semi-continuous ROC type rating scale (0 to 100). The vertical distance, namely the difference in sensitivity levels at the same specificity levels, between the empirical ROC curve and the binary operating point were computed for each reader. The vertical distance averaged over all readers was used to assess the proximity of the performance levels under the binary and ROC-type rating scale. There does not appear to be any systematic tendency for the readers towards a better performance when using either of the two rating approaches, namely 4 readers performed better using the semi-continuous rating scale, 4 readers performed better with the binary scale, and one reader had the point exactly on the empirical ROC curve. Only one of the nine readers had a binary “operating point” that was statistically distant from the same reader’s empirical ROC curve. Reader-specific differences ranged from −0.046 to 0.128 with an average width of the corresponding 95% confidence intervals of 0.2 and p-values ranging for individual readers from 0.050 to 0.966. On average, radiologists performed similarly when using the two rating scales in that the average distance between the individual reader’s binary operating point and their ROC curve was close to zero. The 95% confidence interval for the fixed-reader average (0.016) was (−0.0206, 0.0631) (two-sided p-value 0.35). In conclusion we found that in retrospective observer performance studies the use of a binary response or a semi-continuous rating scale lead to consistent results in terms of performance as measured by sensitivity-specificity operating points.

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Section: Methodsmentioning

confidence: 99%

Binary and multi‐category ratings in a laboratory observer performance study: A comparison

et al. 2008

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“…Beam and Wieand 65 provide a method for comparing one or more continuous diagnostic tests to one discrete diagnostic test. The comparison of areas or partial areas under the curve in this setting may be inappropriate, because even if the sensitivities of a continuous and a discrete test are comparable at all decision limits available to the discrete test, the concavity of the ROC curve of the continuous test ensures it will have larger area under the curve than the discrete test.…”

Section: Sensitivity At Common Speci®citymentioning

confidence: 99%

The interpretation of diagnostic tests

Shapiro

1999

Stat Methods Med Res

232

121

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Laboratory diagnostic tests are central in the practice of modern medicine. Common uses include screening a specific population for evidence of disease and confirming or ruling out a tentative diagnosis in an individual patient. The interpretation of a diagnostic test result depends on both the ability of the test to distinguish diseased from nondiseased subjects and the particular characteristics of the patient and setting in which the test is being used. This article reviews statistical methodology for assessing laboratory diagnostic test accuracy and interpreting individual test results, with an emphasis on diagnostic tests that yield a continuous measurement. The article begins with a summary of basic concepts and terminology, then briefly discusses study design and reviews methods for assessing the accuracy of a single diagnostic test, comparing the accuracy of two or more diagnostic tests and interpreting individual test results.

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“…The null hypothesis of no difference between the STRATIFY (cutoff > 2/5) and the PJC-FRAT falls risk alert card and hip protector recommendation Youden index and Youden index ER were examined using bootstrap comparisons. Area under the receiver operating characteristic curve was not used for these analyses due to its underestimation of the diagnostic accuracy of discrete binary screening instruments [20]. The diagnostic accuracy of physiotherapists and occupational therapists in recommending the exercise and education program interventions were calculated but were not directly compared to those of the STRATIFY because recommendation for these interventions required that patients be able to participate in them and thus only a subset of high risk patients were eligible (which would bias estimates of diagnostic accuracy).…”

Section: Discussionmentioning

confidence: 99%

A new instrument for targeting falls prevention interventions was accurate and clinically applicable in a hospital setting

Haines

Bennell

Osborne

2006

Journal of Clinical Epidemiology

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A Statistical Method for the Comparison of a Discrete Diagnostic Test with Several Continuous Diagnostic Tests

Cited by 23 publications

References 8 publications

Binary and multi‐category ratings in a laboratory observer performance study: A comparison

Binary and multi‐category ratings in a laboratory observer performance study: A comparison

The interpretation of diagnostic tests

A new instrument for targeting falls prevention interventions was accurate and clinically applicable in a hospital setting

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