Assessing accuracy of a continuous screening test in the presence of verification bias
Assessing accuracy of a continuous screening test in the presence of verification bias
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DOI：
10.1111/j.1467-9876.2005.00477.x
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发表时间：
2005-01-01
影响因子：
1.6
通讯作者：
Pepe, MS
中科院分区：
文献类型：
--
作者：
Alonzo, TA;Pepe, MS
在评估筛查试验准确性的研究中，通常确定性疾病评估过于侵入性或昂贵，无法在所有研究受试者中确定。虽然在筛选试验或其他信息提示疾病的研究受试者中以更高的比率确定真实疾病状态可能更符合伦理或成本效益，但在这种设计的研究中，准确性估计可能存在偏倚。这种偏差被称为验证偏差。已经开发了适用于二元或有序响应筛选试验的验证偏倚校正方法;但是，对于具有连续结果的试验，不存在验证偏倚校正方法。我们建议和比较填补和重新加权偏差校正估计的真阳性率和假阳性率，接收器工作特征曲线和接收器工作特征曲线下的面积连续测试。分布理论和模拟研究被用来比较所提出的估计方面的偏差，相对效率和鲁棒性模型误设定。提出的偏差校正估计适用于新生儿听力损失筛查试验的研究数据。
In studies to assess the accuracy of a screening test, often definitive disease assessment is too invasive or expensive to be ascertained on all the study subjects. Although it may be more ethical or cost effective to ascertain the true disease status with a higher rate in study subjects where the screening test or additional information is suggestive of disease, estimates of accuracy can be biased in a study with such a design. This bias is known as verification bias. Verification bias correction methods that accommodate screening tests with binary or ordinal responses have been developed; however, no verification bias correction methods exist for tests with continuous results. We propose and compare imputation and reweighting bias-corrected estimators of true and false positive rates, receiver operating characteristic curves and area under the receiver operating characteristic curve for continuous tests. Distribution theory and simulation studies are used to compare the proposed estimators with respect to bias, relative efficiency and robustness to model misspecification. The bias correction estimators proposed are applied to data from a study of screening tests for neonatal hearing loss.