NEW ROC METHODOLOGY FOR EVALUATION OF DIAGNOSTIC SYSTEMS

评估诊断成像系统和程序是一个重要的 考虑到医疗保健的成本和质量。多夫曼、伯鲍姆和梅茨 (1992)开发了一种新的方法，提供了一种全面的 用于分析接收器工作特性的框架 (RQC)对多个读者进行的研究，同时考虑了 读者样本和病例样本变体。广泛的、长期的目标 是评估、完善和扩大 Dorfman/Berbaum/Metz(DBM)多读取器ROC方法 诊断成像系统的准确性评估。意义重大 在这种方法能够广泛推广之前，还有一些问题需要解决 信心十足地被采用来评估诊断系统。具体的 拟议研究项目的目的是：(1)确定为什么是经验性的 在零假设下，标称错误率有时不同 离散评级格式，并调查降低 这种差异在广泛的实验条件下得以改善 有效性和增强性；(2)决定为什么经验性和 对于连续评级格式，标称错误率有时不同 研究在更大范围内缩小这种差异的程序 提高效度、增加威力的实验条件； 评估DBM多读取器方法在评估中的有效性 不同效应大小差异的可信区间；(4)发展 并评估估计最小读数和案例的程序 检测临床有意义的差异所需的样本量 权力相当大，出现L类型错误的可能性很小；以及 (5)将协变量纳入DBM多读取器方法，以及 评估此扩展的有效性。这些目标将得到解决 采用蒙特卡罗模拟和理论分析相结合的方法。

Evaluation of diagnostic imaging systems and procedures is an important factor in the cost and quality of health care. Dorfman, Berbaum & Metz (1992) developed a new methodology that provides a comprehensive framework within which to analyze receiver operating characteristic (RQC) studies with multiple readers that takes into account both reader-sample and case-sample variation. The broad, long-term objective is to assess, perfect, and extend the useful range of application of the Dorfman/Berbaum/Metz (DBM) multireader ROC methodology for the evaluation of accuracy of diagnostic imaging systems. Significant problems remain to be solved before this approach can be broadly adopted with confidence to evaluate diagnostic systems. The specific aims of the proposed research project are: (1) determine why empirical and nominal error rates sometimes differ under the null hypothesis for the discrete rating format, and investigate procedures for reducing this difference in a broad range of experimental conditions to improve the validity and increase power; (2) determine why empirical and nominal error rates sometimes differ for continuous rating format and to investigate procedures for reducing this difference in a broad range of experimental conditions to improve validity and increase power; (3) evaluate the validity of the DBM multireader methodology in estimating confidence intervals for various effect-size differences; (4) develop and evaluate procedures for estimating the minimum reader and case sample sizes needed to detect a clinically meaningful difference with a fair degree of power and a small probability of a Type l error; and (5) incorporate covariates into the DBM multireader methodology, and evaluate the validity of this extension. These aims will be addressed by both Monte Carlo simulations and theoretical analysis.