Should the intent of testing influence its interpretation?
Should the intent of testing influence its interpretation?
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测试的目的是否应该影响其解释？
DOI：
10.1016/s0735-1097(86)80252-2
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发表时间：
1986
影响因子：
24
通讯作者：
Swan,HJ
中科院分区：
文献类型：
--
作者：
Rozanski,A;Diamond,GA;Forrester,JS;Berman,DS;Morris,D;Jones,RH;Okada,R;Freeman,M;Swan,HJ
一个测试通常被解释为“正常”或“异常”的一个单一的标准，无论测试的意图。使用信息量（I）、似然比和受试者工作特征曲线下面积对该惯例的判别准确性进行了批判性分析。评估三个射血分数变量：静息时射血分数、运动时射血分数和从静息到运动时射血分数的变化，每个变量与三个目标相关：在929例既往无心肌梗死患者中诊断冠状动脉疾病，在这929例患者中预测多支血管疾病，在507例既往有心肌梗死患者中预测多支血管疾病。运动射血分数（IEX）的信息含量高于静息时射血分数（IR）或从静息到运动的变化（IEX-R），并且无论测试目的如何都相对恒定。与此相反，IR和IEX-R都不是恒定的，对于冠状动脉疾病的诊断，R最低，而IEX-R最高。这些经验性观察结果与信息论预测的定量关系一致：IEX=R+ IEX-R。因此，静息时射血分数相对于冠状动脉疾病的诊断几乎没有判别价值，但在评估心肌梗死后患者的疾病程度方面确实有价值。运动射血分数和射血分数变化对诊断几乎同样有用，而前者对梗死后患者的功能评估最有用。在这些观察的基础上，它的结论是，无论是信息内容还是固有的准确性放射性核素心血管造影仍然是固定的测试时，采用不同的，虽然相关的，目的。
A test is often interpreted as "normal" or "abnormal" by a single criterion, regardless of the intent of testing. The discriminate accuracy of this convention was critically analyzed using information content (I), likelihood ratio and the area under the receiver-operating characteristic curve. Three ejection fraction variables were assessed—ejection fraction at rest, exercise ejection fraction and the change in ejection fraction from rest to exercise—each relative to three intentional goals: diagnosis of coronary artery disease in 929 patients without previous myocardial infarction, prediction of multivessel disease in these same 929 patients and prediction of multivessel disease in 507 patients with previous myocardial infarction. The information content of exercise ejection fraction (IEX) was higher than for ejection fraction at rest (IR) or for the change from rest to exercise (IEX-R), and was relatively constant regardless of the goal of testing. In contrast, neither IRnor IEX-Rwas constant.Rwas lowest for diagnosis of coronary artery disease, whereas IEX-Rwas highest for this same goal. These empiric observations are consistent with the quantitative relation predicted by information theory: IEX=R+ IEX-R.Thus, ejection fraction at rest has little discriminate value relative to the diagnosis of coronary artery disease, but does have value in evaluating the extent of disease in patients after myocardial infarction. Exercise ejection fraction and change in ejection fraction are nearly equally useful for purposes of diagnosis, whereas the former is most useful for functional evaluation in postinfarction patients. On the basis of these observations, it is concluded that neither the information content nor the inherent accuracy of radionuclide angiocardiogeaphy remains fixed when the test is employed for different, although related, purposes.