Assessing diagnostic tests: how to correct for the combined effects of interpretation and reference standard.

Assessing diagnostic tests: how to correct for the combined effects of interpretation and reference standard.
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DOI:
10.1371/journal.pone.0052221
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发表时间:
2012
期刊:
影响因子:
3.7
通讯作者:
Fenton AA
Fenton AA
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Omurtag A;Fenton AA

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我们描述了一个通用的解决方案,以确定诊断准确性的问题,而不使用一个完美的参考标准,并在存在解释器的变化。诊断测试的准确性通常通过将其结果与已建立的参考标准的结果进行比较来确定。但标准本身的准确性和口译员的准确性强烈影响着这种评估。我们使用我们的解决方案来检查标准的属性,口译员的可靠性,以及异常的患病率对测量的灵敏度和特异性的影响。我们的研究结果提供了一种系统地调整测量的灵敏度和特异性,以估计其真实值的方法。仿真结果进行了验证,并详细介绍了其应用到具体情况。
We describe a general solution to the problem of determining diagnostic accuracy without the use of a perfect reference standard and in the presence of interpreter variability. The accuracy of a diagnostic test is typically determined by comparing its outcomes with those of an established reference standard. But the accuracy of the standard itself and those of the interpreters strongly influence such assessments. We use our solution to examine the effects of the properties of the standard, the reliability of the interpreters, and the prevalence of abnormality on the measured sensitivity and specificity. Our results provide a method of systematically adjusting the measured sensitivity and specificity in order to estimate their true values. The results are validated by simulations and their detailed application to specific cases are described.
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