Confidence intervals for predictive values with an emphasis to case-control studies
Confidence intervals for predictive values with an emphasis to case-control studies
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DOI：
10.1002/sim.2677
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发表时间：
2007-05-10
影响因子：
2
通讯作者：
Zhou, Xiao H.
中科院分区：
文献类型：
--
作者：
Mercaldo, Nathaniel D.;Lau, Kit F.;Zhou, Xiao H.
二进制诊断试验的准确性可以用敏感度(Se)、特异度(Sp)以及阳性预测值和阴性预测值(PPV和NPV)来表示。虽然Se和Sp衡量的是不依赖于患病率的诊断测试的内在准确性，但它们不提供关于特定患者诊断准确性的信息。为了获得这些信息，我们需要使用PPV和NPV。由于PPV和NPV是检测准确性和疾病流行率的函数，因此为特定患者构建它们的可信区间并非易事。本文提出了一种新的PPV和NPV估计方法及其可信区间。在模拟研究中，对于这两个预测值，使用覆盖概率和区间长度来比较标准的、调整的和它们基于Logit变换的可信区间。这些方法随后被应用于两项病例对照研究：一项诊断试验评估载脂蛋白E基因(ApoE.e4)的e4等位基因对区分晚发性阿尔茨海默病(AD)患者的能力；另一项预后试验评估70基因标记对乳腺癌转移的预测能力。版权所有(C)2006 John Wiley&Sons，Ltd.
The accuracy of a binary-scale diagnostic test can be represented by sensitivity (Se), specificity (Sp) and positive and negative predictive values (PPV and NPV). Although Se and Sp measure the intrinsic accuracy of a diagnostic test that does not depend on the prevalence rate, they do not provide information on the diagnostic accuracy of a particular patient. To obtain this information we need to use PPV and NPV. Since PPV and NPV are functions of both the accuracy of the test and the prevalence of the disease, constructing their confidence intervals for a particular patient is not straightforward. In this paper, a novel method for the estimation of PPV and NPV, as well as their confidence intervals, is developed. For both predictive values, standard, adjusted and their logit transformed-based confidence intervals are compared using coverage probabilities and interval lengths in a simulation study. These methods are then applied to two case-control studies: a diagnostic test assessing the ability of the e4 allele of the apolipoprotein E gene (ApoE.e4) on distinguishing patients with late-onset Alzheimer's disease (AD) and a prognostic test assessing the predictive ability of a 70-gene signature on breast cancer metastasis. Copyright (c) 2006 John Wiley & Sons, Ltd.