Evaluation and optimization of diagnostic tests using receiver operating characteristic analysis and information theory |
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| Institution: | 1. Psychiatry Service, Veterans'' Administration Medical Center, Cincinnati, OH 45220 U.S.A.;2. Division of Neuroscience, Psychiatry Department, University of Cincinnati Medical Center, Cincinnati, OH 45267-0559 U.S.A.;3. Economics Department, Universidad Autonoma de Madrid, Canto Blanco Madrid, Spain;4. Millcreek Psychiatric Center for Children, 66th Street and Paddock Road, Cincinnati, OH 45216 U.S.A.;5. Department of Psychiatry, University of Cincinnati Medical Center, Cincinnati, OH 45267-0559 U.S.A.;1. Department of Surgery, University of Texas Medical Branch, Galveston, Texas;2. Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas;1. Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China;2. Department of Surgery, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China;3. Department of Neurology, The Second People''s Hospital of Jiaxing, Jiaxing, Zhejiang Province, China;1. Instituto Nacional de Investigação Agrária e Veterinária (INIAV, IP), Estrada de Benfica 701, 1549-011 Lisboa, Portugal;2. Centro de Recursos Microbiológicos (CREM), Departamento de Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus da Caparica, 2829-516 Caparica, Portugal;3. Grupo de Micobactérias, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical da Universidade Nova deLisboa (IHMT/UNL), Rua da Junqueira, 100, 1349-008 Lisboa, Portugal;4. School of Pharmacy and Biomolecular Sciences, University of Brighton, Lewes Road, Brighton BN2 4GJ, United Kingdom |
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| Abstract: | We describe a mathematical technique and an associated computer program for comparing, evaluating and optimizing diagnostic tests. The technique combines receiver operating characteristic (ROC) analysis with information theory and cost-benefit analysis to accomplish this. The program is menu driven and highly interactive; it generates 13 possible user-determined ASCII disk files which can be easily converted to graphs. These graphs allow the user to make detailed comparisons among various diagnostic tests for all values of disorder prevalence, and also provide guidelines for cut-off selection in order to optimize tests. These techniques are applied to three published studies of the enzyme screening assay for diagnosis of infection with the HIV virus. We show how graphs produced by this program can be used to compare and optimize these diagnostic tests. The program is written for an IBM-compatible microcomputer running on a DOS operating system. |
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