The use of imperfect diagnostic tests had an impact on prevalence estimation
The use of imperfect diagnostic tests had an impact on prevalence estimation
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DOI：
10.1016/j.jclinepi.2006.11.016
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发表时间：
2007-09-01
影响因子：
7.2
通讯作者：
Schumacher, M.
中科院分区：
文献类型：
--
作者：
Ihorst, G.;Forster, J.;Schumacher, M.
目的：当两种不完全诊断试验同时应用时，敏感性和特异性的估计所引起的问题被广泛讨论。对流行率估计的影响可能也很重要。不同的方法处理两个或两个以上的不完善的测试和未知的参考标准进行了对比，就其对患病率估计的影响：差异分析，复合参考标准，和潜在的类models.Study设计和设置：前瞻性多中心流行病学研究，以确定呼吸道合胞病毒在儿童下呼吸道感染的患病率。考虑了来自医院人群和实践人群的1，003例患者的子样本。结果：在不同假设条件下，医院人群的患病率估计值为0.263 ~ 0.386，而医务人员的患病率估计值为0.214 ~ 0.277。估计程序涉及的解析器测试适用于一些，但不是所有的细胞是在风险，介绍了一个严重的偏见，以及患病率估计如在测试精度参数的估计中。通过潜在类建模进行估计可能更有用，但应注意基本假设。(c)2007年爱思唯尔公司All rights reserved.
Objective: Problems arising with the estimation of sensitivity and specificity when two imperfect diagnostic tests are applied are widely discussed. Effects on the estimation of prevalence may be of importance as well. Different methods of dealing with two or more imperfect tests and unknown reference standard are contrasted with regard to their implications on prevalence estimation: discrepant analysis, composite reference standards, and latent class models.Study Design and Setting: Prospective epidemiological multicenter study to determine the prevalence of respiratory syncytial virus in children with lower respiratory tract infections. A subsample of 1,003 patients from a hospital population and from a practice population is considered. Virus isolation, polymerase chain reaction, and rapid antigen test had been applied.Results: Prevalence estimates obtained under various assumptions ranged from 0.263 to 0.386 in the hospital population and from 0.214 to 0.277 in the practice population.Conclusion: Estimation procedures involving a resolver test applied to some but not all cells are at risk of introducing a serious bias in prevalence estimation as well as in the estimation of test accuracy parameters. Estimation via latent class modeling may be more useful, but care should be taken regarding the underlying assumptions. (c) 2007 Elsevier Inc. All rights reserved.