Advantages of the nested case-control design in diagnostic research
Advantages of the nested case-control design in diagnostic research
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DOI：
10.1186/1471-2288-8-48
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发表时间：
2008-07-21
影响因子：
4
通讯作者：
Moons, Karel Gm
中科院分区：
文献类型：
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作者：
Biesheuvel, Cornelis J.;Vergouwe, Yvonne;Moons, Karel Gm
背景：尽管巢式病例对照设计有其优点，但在诊断研究中应用巢式病例对照设计并不常见。我们的目的是显示这种设计的诊断准确性study.Methods的优势：我们使用的数据，从一个完整的横断面诊断研究，包括一个队列的1295例连续患者谁被选为他们怀疑有深静脉血栓形成（DVT）。我们从整个研究人群中抽取巢式病例对照样本，病例：对照比例为1：1、1：2、1：3和1：4（每个比例采集100份样本）。我们计算了诊断准确性估计用于检测DVT在临床practice.Results的两个测试：嵌套病例对照样本的诊断准确性估计是非常相似的，在整个研究人群。例如，对于每个病例：对照比，D-二聚体检测的阳性预测值在全研究人群中为0.30，在巢式病例-对照样本中为0.30（100份样本的中位数）。正如预期的那样，变异性的估计随着样本量的增加而下降。结论：我们的研究结果支持认为，巢式病例对照研究是一个有效的和高效的设计诊断研究，也应该（重新）评估在目前的指南诊断准确性研究。
Background: Despite its benefits, it is uncommon to apply the nested case-control design in diagnostic research. We aim to show advantages of this design for diagnostic accuracy studies.Methods: We used data from a full cross-sectional diagnostic study comprising a cohort of 1295 consecutive patients who were selected on their suspicion of having deep vein thrombosis (DVT). We draw nested case-control samples from the full study population with case: control ratios of 1: 1, 1: 2, 1: 3 and 1: 4 ( per ratio 100 samples were taken). We calculated diagnostic accuracy estimates for two tests that are used to detect DVT in clinical practice.Results: Estimates of diagnostic accuracy in the nested case-control samples were very similar to those in the full study population. For example, for each case: control ratio, the positive predictive value of the D-dimer test was 0.30 in the full study population and 0.30 in the nested case-control samples ( median of the 100 samples). As expected, variability of the estimates decreased with increasing sample size.Conclusion: Our findings support the view that the nested case-control study is a valid and efficient design for diagnostic studies and should also be ( re) appraised in current guidelines on diagnostic accuracy research.