INTEGRATING STRATUM-SPECIFIC LIKELIHOOD RATIOS WITH THE ANALYSIS OF ROC CURVES
INTEGRATING STRATUM-SPECIFIC LIKELIHOOD RATIOS WITH THE ANALYSIS OF ROC CURVES
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DOI：
10.1177/0272989x9301300208
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发表时间：
1993-04-01
影响因子：
3.6
通讯作者：
CORNELL, RG
中科院分区：
文献类型：
--
作者：
PEIRCE, JC;CORNELL, RG
用于构建受试者工作特征（ROC）曲线和计算曲线下面积（ROC AUC）的数据可用于推导具有95%置信区间（95%CI）的层特异性似然比（SSLR）。本研究的目的是确定是否可以获得有用的信息，通过添加SSR的ROC曲线的分析。作者分析了4组先前报告的数据：1）血清肌酸激酶（SCK）用于诊断冠心病监护室（CCU）中的急性心肌梗死（AMI）; 2）SCK用于评价急诊中心（EC）中的胸痛; 3）诊断链球菌性咽喉炎的4个预测变量; 4）计算机断层扫描（CT）图像的顺序评估。在CCU中使用SCK产生了四个具有高度区分的后测概率的层，而在EC中使用SCK只产生了两个区分能力有限的层。在任一研究中，SSLR从小于1.0变为大于1.0的临界点高于试验报告的正常上限，从而定量光谱偏倚。链球菌性咽喉炎的预测体征和症状的最大分层数为3，而不是以前研究中使用的5。随着样本量的增加或合并，可能会形成四个层次。在CT图像中，“肯定正常”、"可能正常“和”可疑"被分解为一个阴性层。“可能异常”成为真正的“可疑”层，“肯定异常”是唯一的积极层。作者得出结论，通过推导特定层的似然比作为ROC曲线分析的一部分，可以获得额外的有用信息。
Data used to construct receiver operating characteristic (ROC) curves and to calculate the area under the curve (ROC AUC) can be used to derive stratum-specific likelihood ratios (SSLRs) with their 95% confidence intervals (95% CIs). The purpose of this study was to determine whether useful information can be obtained by adding SSLRs to the analysis of ROC curves. The authors analyzed four previously reported sets of data: 1) serum creatine kinase (SCK) for diagnosing acute myocardial infarction (AMI) in the coronary care unit (CCU); 2) SCK in the evaluation of chest pain in the emergency center (EC); 3) four predictor variables in the diagnosis of strep throat; and 4) the ordinal assessment of computed tomographic (CT) images. Use of SCK in the CCU produced four strata that had posttest probabilities that were highly discriminating, whereas SCK in the EC resulted in only two strata with limited discriminating ability. In either study the cutpoint at which the SSLR changed from less than to greater than 1.0 was higher than the reported upper normal for the test, thereby quantitating spectrum bias. The maximum number of strata of predictor signs and symptoms for strep throat was three rather than the five used in previous studies. With a larger sample size or pooling, four strata could probably be developed. With CT images, ''definitely normal,'' ''probably normal,'' and ''questionable'' were collapsed to one negative stratum. ''Probably abnormal'' became the true ''questionable'' stratum and ''definitely abnormal'' was the only positive stratum. The authors conclude that additional useful information is obtained by deriving stratum-specific likelihood ratios as part of the analysis of an ROC curve.