Statistical Evaluation of Diagnostic Performance

Statistical Evaluation of Diagnostic Performance
Author: Kelly H. Zou
Publisher: CRC Press
Total Pages: 249
Release: 2011-07-27
Genre: Mathematics
ISBN: 1439812225

Statistical evaluation of diagnostic performance in general and Receiver Operating Characteristic (ROC) analysis in particular are important for assessing the performance of medical tests and statistical classifiers, as well as for evaluating predictive models or algorithms. This book presents innovative approaches in ROC analysis, which are relevant to a wide variety of applications, including medical imaging, cancer research, epidemiology, and bioinformatics. Statistical Evaluation of Diagnostic Performance: Topics in ROC Analysis covers areas including monotone-transformation techniques in parametric ROC analysis, ROC methods for combined and pooled biomarkers, Bayesian hierarchical transformation models, sequential designs and inferences in the ROC setting, predictive modeling, multireader ROC analysis, and free-response ROC (FROC) methodology. The book is suitable for graduate-level students and researchers in statistics, biostatistics, epidemiology, public health, biomedical engineering, radiology, medical imaging, biomedical informatics, and other closely related fields. Additionally, clinical researchers and practicing statisticians in academia, industry, and government could benefit from the presentation of such important and yet frequently overlooked topics.

Statistical Methods in Diagnostic Medicine

Statistical Methods in Diagnostic Medicine
Author: Xiao-Hua Zhou
Publisher: John Wiley & Sons
Total Pages: 597
Release: 2011-03-29
Genre: Medical
ISBN: 0470183144

Praise for the First Edition " . . . the book is a valuable addition to the literature in the field, serving as a much-needed guide for both clinicians and advanced students."—Zentralblatt MATH A new edition of the cutting-edge guide to diagnostic tests in medical research In recent years, a considerable amount of research has focused on evolving methods for designing and analyzing diagnostic accuracy studies. Statistical Methods in Diagnostic Medicine, Second Edition continues to provide a comprehensive approach to the topic, guiding readers through the necessary practices for understanding these studies and generalizing the results to patient populations. Following a basic introduction to measuring test accuracy and study design, the authors successfully define various measures of diagnostic accuracy, describe strategies for designing diagnostic accuracy studies, and present key statistical methods for estimating and comparing test accuracy. Topics new to the Second Edition include: Methods for tests designed to detect and locate lesions Recommendations for covariate-adjustment Methods for estimating and comparing predictive values and sample size calculations Correcting techniques for verification and imperfect standard biases Sample size calculation for multiple reader studies when pilot data are available Updated meta-analysis methods, now incorporating random effects Three case studies thoroughly showcase some of the questions and statistical issues that arise in diagnostic medicine, with all associated data provided in detailed appendices. A related web site features Fortran, SAS®, and R software packages so that readers can conduct their own analyses. Statistical Methods in Diagnostic Medicine, Second Edition is an excellent supplement for biostatistics courses at the graduate level. It also serves as a valuable reference for clinicians and researchers working in the fields of medicine, epidemiology, and biostatistics.

Biostatistics for Radiologists

Biostatistics for Radiologists
Author: Francesco Sardanelli
Publisher: Springer Science & Business Media
Total Pages: 244
Release: 2009-03-31
Genre: Medical
ISBN: 8847011337

The aim of this book is to present statistical problems and methods in a friendly way to radiologists, emphasizing statistical issues and methods most frequently used in radiological studies (e.g., nonparametric tests, analysis of intra- and interobserver reproducibility, comparison of sensitivity and specificity among different imaging modality, difference between clinical and screening application of diagnostic tests, ect.). The tests will be presented starting from a radiological "problem" and all examples of statistical methods applications will be "radiological".

Statistical Methods for Combining Diagnostic Tests and Performance Evaluation Metrics

Statistical Methods for Combining Diagnostic Tests and Performance Evaluation Metrics
Author: Chengning Zhang (Ph.D.)
Publisher:
Total Pages: 0
Release: 2022
Genre:
ISBN:

In biomedical studies, it is usually the case that several diagnostic tests can be performedon an individual or multiple disease markers are available simultaneously, and that many of them may be associated with the clinical outcome. In practice, a single test or marker often has limited diagnostic performance. Therefore, it is important to combine multiple sources of information available to achieve higher classification performance. This dissertation focuses on statistical methods for combining multiple diagnostic tests and the corresponding performance evaluation metrics. In the first project, we provide a survey of the current state of the art in methods for combining multiple tests. We categorize existing methods into three general groups and conduct extensive simulation studies to compare the performance of different combination methods. The reviewed methods serve as benchmark for developing new combination approaches in the following projects. In the second project, we consider the problem of combining multiple tests whose values are missing at random (MAR). In addition, we aim to exploit the known monotonicity relationship between the input variables and the disease outcome for gains in diagnostic accuracy. We develop a novel likelihood-based approach to monotone classification that accounts for missing inputs in a natural and principled way. The risk score function is obtained through the nonparametric maximum likelihood estimation (NPMLE). A novel expectation-maximization (EM)-type algorithm is devised to compute the NPMLE by treating the monotonicity-constrained risk score function as a cumulative distribution for a latent random vector. Through simulation studies and a real data example, we demonstrate that the proposed method outperforms state-of-the-art methods for combining multiple inputs under monotonic assumption, especially when the inputs contain missing data. We illustrate our approach with a dataset from a recent nonalcoholic fatty liver disease (NALFD) study. In the third project, our approach established in the second part is extended to the scenario where one covariate is randomly censored. The proposed approach consists of two steps. In step one, we use a Cox proportional hazards model for the distribution of the censored covariate given other covariates in the model, this conditional distribution is used for calculating the observed likelihood of data. In step two, a similar expectation maximization (EM)-type algorithm is devised, based on observed data likelihood from step one, to compute the NPMLE of the monotonicity-constrained risk score function. Through simulation studies, we demonstrate that the proposed method outperforms the simple but inefficient complete-case analysis as well as the substitution methods. We apply our method to the data set from a primary biliary cirrhosis (PBC) study conducted at Mayo Clinic. The proposed methods in part two and three can be extended to multi-class cases, where the labels have an inherent order but no meaningful numeric distance between them. A natural question arises as to how to evaluate the classification performance under such setting. Therefore, in the fourth project, we consider the problem of performance evaluation metrics for ordinal classification. We propose three novel performance evaluation metrics that better capture the ordinality of the outcomes. The first metric is adapted from the area under the receiver operating characteristic (ROC) curve (AUC), while the latter two are simple and interpretable generalizations of the Harrell's concordance index (C-INDEX). Moreover, we show the optimality of the AUC based metrics through Neyman-Pearson lemma. We conduct extensive simulation studies to confirm the usefulness of the proposed performance metrics for ordinal classification.

Assessment of Diagnostic Technology in Health Care

Assessment of Diagnostic Technology in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 152
Release: 1989-02-01
Genre: Medical
ISBN: 030904099X

Technology assessment can lead to the rapid application of essential diagnostic technologies and prevent the wide diffusion of marginally useful methods. In both of these ways, it can increase quality of care and decrease the cost of health care. This comprehensive monograph carefully explores methods of and barriers to diagnostic technology assessment and describes both the rationale and the guidelines for meaningful evaluation. While proposing a multi-institutional approach, it emphasizes some of the problems involved and defines a mechanism for improving the evaluation and use of medical technology and essential resources needed to enhance patient care.

Evaluation of Diagnostic Systems

Evaluation of Diagnostic Systems
Author: John Swets
Publisher: Academic Press
Total Pages: 280
Release: 1982-01-28
Genre: Psychology
ISBN:

Evaluation of Diagnostic Systems: Methods from Signal Detection Theory addresses the many issues that arise in evaluating the performance of a diagnostic system, across the wide range of settings in which such systems are used. These settings include clinical medicine, industrial quality control, environmental monitoring and investigation, machine and metals inspection, military monitoring, information retrieval, and crime investigation. The book is divided into three parts encompassing 11 chapters that emphasize the interpretation of diagnostic visual images by human observers. The first part of the book describes quantitative methods for measuring the accuracy of a system and the statistical techniques for drawing inferences from performance tests. The subsequent part covers study design and includes a detailed description of the form and conduct of an image-interpretation test. The concluding part examines the case study of a medical imaging system that serves as an example of both simple and complex applications. In this part, three mammographic modalities are used: industrial film radiography, low-dose film radiography, and xeroradiography. The case study focuses on the overall reliability of accuracy indices made by its main components, that is, the variabilities across cases, across readers, and within individual readers. The supplementary texts provide study protocols, a computer program for processing test results, and an extensive list of references that will assist the reader in applying those evaluative methods to diagnostic systems in any setting. This book is of value to scientists and engineers, as well as to applied, quantitative, or experimental psychologists who are engaged in the study of the human processes of discrimination and decision making in either perceptual or cognitive tasks.

ROC Curves for Continuous Data

ROC Curves for Continuous Data
Author: Wojtek J. Krzanowski
Publisher: CRC Press
Total Pages: 256
Release: 2009-05-21
Genre: Business & Economics
ISBN: 1439800227

Since ROC curves have become ubiquitous in many application areas, the various advances have been scattered across disparate articles and texts. ROC Curves for Continuous Data is the first book solely devoted to the subject, bringing together all the relevant material to provide a clear understanding of how to analyze ROC curves.The fundamenta

Methodology for Evaluation of Diagnostic Performance

Methodology for Evaluation of Diagnostic Performance
Author:
Publisher:
Total Pages:
Release: 2003
Genre:
ISBN:

The proliferation of expensive technology in diagnostic medicine demands objective, meaningful assessments of diagnostic performance. Receiver Operating Characteristic (ROC) analysis is now recognized widely as the best approach to the task of measuring and specifying diagnostic accuracy (Metz, 1978; Swets and Pickett, 1982; Beck and Schultz, 1986; Metz, 1986; Hanley, 1989; Zweig and Campbell, 1993), which is defined as the extent to which diagnoses agree with actual states of health or disease (Fryback and Thornbury, 1991; National Council on Radiation Protection and Measurements, 1995). The primary advantage of ROC analysis over alternative methodologies is that it separates differences among diagnostic decisions that are due to actual differences in discrimination capacity from those that are due to decision-threshold effects (e.g., ''under-reading'' or ''over-reading''). An ROC curve measures diagnostic accuracy by displaying True Positive Fraction (TPF: the fraction of patients actually having the disease in question that is diagnosed correctly as ''positive'') as a function of False Positive Fraction (FPF: the fraction of patients actually without the disease that is diagnosed incorrectly as ''positive''). Different points on the ROC curve--i.e., different compromises between the specificity and the sensitivity of a diagnostic test, for a given inherent accuracy--can be achieved by adopting different critical values of the diagnostic test's ''decision variable'' --e.g., the observer's degree of confidence that each case is positive or negative in a diagnostic image-reading task, or the numerical value of the result of a quantitative diagnostic test. ROC techniques have been used to measure and specify the diagnostic performance of medical imaging systems since the early 1970s, and the needs that arise in this application have spurred a variety of new methodological developments. In particular, substantial progress has been made in ROC curve fitting and in developing statistical tests to evaluate the significance of measured differences between ROC curves. These are especially important tasks in medical applications, because various practical issues usually limit the number of patients with clearly established diagnostic truth that can be included in any study that seeks to measure diagnostic performance objectively. Other progress has been made in relating ROC analysis to cost/benefit analysis, and in generalizing ROC methods to accommodate some diagnostic tasks where more than two decision alternatives are available. ROC analysis clearly provides the most rigorous and fruitful approach for such assessments but, like many other powerful techniques that provide useful insight concerning complex situations, it currently suffers from limitations, particularly in evaluation studies that involve small case samples. However, the potential of this relatively new analytic approach and the concepts on which it is based have not been fully explored. The research proposed here is designed to refine and supplement existing ROC methodology to increase both the accuracy and the precision of its results.