Measuring and estimating diagnostic accuracy when there are three ordinal diagnostic groups
Measuring and estimating diagnostic accuracy when there are three ordinal diagnostic groups
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DOI：
10.1002/sim.2433
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发表时间：
2006-04-15
影响因子：
2
通讯作者：
Morris, JC
中科院分区：
文献类型：
--
作者：
Xiong, CJ;van Belle, G;Morris, JC
本文研究了有三个有序诊断组时诊断精度的测量和估计问题。我们使用受试者工作特征（ROC）表面来描述基于测试的不同诊断阈值集的正确分类为三个诊断组的概率，并建议使用表面下的全部和部分体积来衡量诊断准确性。讨论了所提出的诊断精度度量的数学性质和概率解释。在三个诊断组的诊断检验的正态分布的假设下，我们给出了ROC曲面下体积的最大似然估计，并给出了估计的渐近方差。我们进一步提出了对ROC曲面下体积的几个渐近置信区间估计。在仿真研究的基础上，从获得名义覆盖概率的角度对这些置信区间估计的性能进行了评估。此外，我们开发了一种确定样本量的方法，以达到足够的置信区间估计的准确性。最后，我们将提出的方法应用于基于华盛顿大学阿尔茨海默病研究中心的神经心理学数据库的早期阿尔茨海默病的临床诊断。版权所有(c) 2005 John Wiley & Sons, Ltd。
This article studies the problem of measuring and estimating the diagnostic accuracy when there are three ordinal diagnostic groups. We use a receiver operating characteristic (ROC) surface to describe the probabilities of correct classifications into three diagnostic groups based on various sets of diagnostic thresholds of a test and propose to use the entire and the partial volume under the surface to measure the diagnostic accuracy. Mathematical properties and probabilistic interpretations of the proposed measure of diagnostic accuracy are discussed. Under the assumption of normal distributions of the diagnostic test from three diagnostic groups, we present the maximum likelihood estimate to the volume under the ROC surface and give the asymptotic variance to the estimate. We further propose several asymptotic confidence interval estimates to the volume under the ROC surface. The performance of these confidence interval estimates is evaluated in terms of attaining the nominal coverage probability based on a simulation study. In addition, we develop a method of sample size determination to achieve an adequate accuracy of the confidence interval estimate. Finally, we demonstrate the proposed methodology by applying it to the clinical diagnosis of early stage Alzheimer's disease based on the neuropsychological database of the Washington University Alzheimer's Disease Research Center. Copyright (c) 2005 John Wiley & Sons, Ltd.