Comparing the sensitivities and specificities of two diagnostic procedures performed on the same group of patients
Comparing the sensitivities and specificities of two diagnostic procedures performed on the same group of patients
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DOI：
10.1259/bjr.70.832.9166071
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发表时间：
1997-04-01
影响因子：
2.6
通讯作者：
Hawass, NED
中科院分区：
文献类型：
--
作者：
Hawass, NED
诊断准确性研究是最常进行的诊断测试。这些是通过使用决策矩阵表进行的，其中计算和比较了灵敏度，特异性，预测值和其他比率。已经报道了这种方法的各种可恢复的缺陷和局限性。本研究报告了使用该方法作为统计分析工具的其他进一步限制。决策协议和公式，以显示如何测试的灵敏度和特异性进行比较，以作出决定。该研究还显示了如何为比较诊断测试的四个结果（真阳性，真阴性，假阳性和假阴性）构建特殊的表，并注意不要使用一些2x2列联表。介绍了如何使用这些特殊的表格和公式比较灵敏度和特异性以及推导其差异的置信区间的步骤。它还表明，它是如何可能的，使一个单一的推理诊断测试的性能，这将允许确定哪个测试是更好的。
Studies of diagnostic accuracy are the most commonly performed diagnostic tests. These are carried out by using Decision Matrix tables in which sensitivities, specificities, predictive values and other ratios are calculated and compared. Various recoverable pitfalls and limitations of this method have been reported. This study reports additional further limitations of using this method as a statistical analytical tool. Decision protocols and formulae are presented to show how the sensitivities and specificities of tests are compared in order to make a decision. The study also shows how special tables can be constructed for the four results of comparative diagnostic tests (true positive, true negative, false positive and false negative), and cautions against the use of some 2 x 2 contingency tables. The procedures of how to use these special tables and formulae for comparing sensitivity and specificity and deriving confidence intervals for their difference are presented. It is also shown how it is possible to make a single inference from diagnostic test performance which will permit the determination of which test is better.