Assessing the diagnostic accuracy of a sequence of tests
Assessing the diagnostic accuracy of a sequence of tests
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DOI：
10.1093/biostatistics/4.3.341
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发表时间：
2003-07-01
期刊：
影响因子：
2.1
通讯作者：
Thompson, ML
中科院分区：
文献类型：
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作者：
Thompson, ML
我们考虑评估一系列测试（如重复筛选测试）的总体诊断准确性。诊断选择的复杂性，当两个或更多的连续测试是按顺序使用说明，并提出了不同的方法来降低维数和评估。例如，在实践中，当在常规筛查中重复使用单一测试时，通常在每次筛查访问中使用相同的筛查阈值。一种可能的替代方案是根据个人具体特征调整连续访问的阈值。这种可能性表示接收机工作特性表面的特定切片，对应于测试阈值的所有可能组合。在开发和示例中，我们将重点放在这样的设置上：如果任何单个测试都是阳性的，则将整体测试定义为阳性（“相信阳性”）。通过一个应用前列腺特异性抗原筛选前列腺癌的例子说明了所发展的思想。
We consider the assessment of the overall diagnostic accuracy of a sequence of tests (e.g. repeated screening tests). The complexity of diagnostic choices when two or more continuous tests are used in sequence is illustrated, and different approaches to reducing the dimensionality are presented and evaluated. For instance, in practice, when a single test is used repeatedly in routine screening, the same screening threshold is typically used at each screening visit. One possible alternative is to adjust the threshold at successive visits according to individual-specific characteristics. Such possibilities represent a particular slice of a receiver operating characteristic surface, corresponding to all possible combinations of test thresholds. We focus in the development and examples on the setting where an overall test is defined to be positive if any of the individual tests are positive ('believe the positive'). The ideas developed are illustrated by an example of application to screening for prostate cancer using prostate-specific antigen.