Abstract
This chapter outlines the principles of designing, performing and interpreting high quality studies of diagnostic test accuracy. The basic concepts of diagnostic test accuracy, including sensitivity, spec-ificity, diagnostic odds ratio (DOR), likelihood ratios (LRs) and predictive values, are explained. Sources of bias in diagnostic test accuracy studies are explained with practical examples. The graphical ways to represent the accuracy of a diagnostic test are demonstrated. Issues to consider when interpreting the quality of a published study of test accuracy are outlined using guidelines advocated in the medical literature. Finally, the principles of diagnostic meta-analysis, including bivariate and hierarchical summary receiver operating characteristic methods, are explained.
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Abbreviations
- AUC:
-
Area under the curve
- DOR:
-
Diagnostic odds ratio
- FN:
-
False negative
- FP:
-
False positive
- FPR:
-
False positive rate
- HSROC:
-
Hierarchical summary receiver operating characteristic
- LR:
-
Likelihood ratio
- NPV:
-
Negative predictive value
- PPV:
-
Positive predictive value
- QUADAS:
-
Quality assessment of diagnostic accuracy studies
- RDOR:
-
Relative diagnostic odds ratio
- ROC:
-
Receiver operating characteristic
- SROC:
-
Summary receiver operating characteristic
- STARD:
-
Standards for reporting of diagnostic accuracy
- TN:
-
True negative
- TP:
-
True positive
- TPR:
-
True positive rate
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List of Useful Websites
Loong T. (2003) Understanding sensitivity and specificity with the right side of the brain. BMJ 2003;327:716–719. http://www.bmj.com/cgi/content/full/327/7417/716
Altman DG, Bland JM (1994).
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Jones, C.M., Darzi, L.A., Athanasiou, T. (2010). Diagnostic Tests and Diagnostic Accuracy in Surgery. In: Athanasiou, T., Debas, H., Darzi, A. (eds) Key Topics in Surgical Research and Methodology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-71915-1_8
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DOI: https://doi.org/10.1007/978-3-540-71915-1_8
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