A parametric comparison of diagnostic accuracy with three ordinal diagnostic groups
A parametric comparison of diagnostic accuracy with three ordinal diagnostic groups
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DOI：
10.1002/bimj.200610359
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发表时间：
2007-08-01
影响因子：
1.7
通讯作者：
Morris, John C.
中科院分区：
文献类型：
--
作者：
Xiong, Chengjie;van Belle, Gerald;Morris, John C.
许多医学诊断研究涉及三个顺序诊断组，其中诊断准确性可以通过受试者工作特征（ROC）曲面下的体积或部分体积来概括。本文研究了当涉及三个有序诊断组时，多重诊断试验诊断准确性的统计比较。在多个诊断测试遵循多元正态分布的假设下，每个诊断组内，我们提供了渐近方差和协方差的最大似然估计的ROC表面下的体积从多个诊断测试，并提出统计测试，以测试是否诊断准确性测量的ROC表面下的体积是相同的多个诊断测试。我们还提出了一个置信区间估计两个ROC曲面下的两个体积的差异。我们的方法在很大程度上依赖于诊断测试的正态分布假设，当违反这些假设时，这些假设可能不可靠。最后，我们将我们提出的方法应用于118名受试者的真实的数据集，以比较多种神经心理学测试对早期阿尔茨海默病（AD）的诊断准确性。
Many medical diagnostic studies involve three ordinal diagnostic groups in which the diagnostic accuracy can be summarized by the volume or partial volume under a Receiver Operating Characteristic (ROC) surface. We study in this paper the statistical comparison of diagnostic accuracy from multiple diagnostic tests when three ordinal diagnostic groups are involved. Under the assumption that the multiple diagnostic tests follow a multivariate normal distribution within each diagnostic group, we provide the asymptotic variance and covariance for the maximum likelihood estimates of the volumes under the ROC surfaces from multiple diagnostic tests and propose statistical tests to test whether the diagnostic accuracy as measured by the volume under the ROC surface is the same for multiple diagnostic tests. We also propose a confidence interval estimate to the difference of two volumes under two ROC surfaces. Our approach depends crucially on the assumptions of normal distributions on diagnostic tests, which might not be robust when such assumptions are violated. Finally, we apply our proposed methodology to a real data set of 118 subjects to compare the diagnostic accuracy of early stage Alzheimer's disease (AD) from multiple neuropsychological tests.