Medical Decision Making

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Register here to gain access to SAGE's 500+ Journals Online

Click here to browse AJSM online!

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Zou, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zou, G.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Medical Decision Making, Vol. 24, No. 3, 313-318 (2004)
DOI: 10.1177/0272989X04265483

From Diagnostic Accuracy to Accurate Diagnosis: Interpreting a Test Result with Confidence

Guangyong Zou, PhD

Robarts Research Institute and the Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada

Background. The Standard for Reporting of Diagnostic Accuracy statement promotes the reporting of confidence intervals (CIs) for indices of diagnostic test accuracy. However, these indices must be combined with an estimate of pretest probability to properly interpret the results of such tests, thus yielding positive and negative predictive values. For small sample sizes, CI estimation for predictive values based on the classical logit transformation has been found to be very conservative. A method based on computer simulation has therefore been suggested as an alternative. Methods. ACI procedure for predictive values that yields limits completely contained in those provided by the logit transformation is proposed and evaluated. Results. The proposed approach to CI construction maintains nominal coverage very well even when sample sizes are small. Conclusion. Accurate CIs for positive and negative predictive values can be obtained without using computer simulation.

Key Words: Bayes’s theorem • confidence interval • delta method • diagnostic accuracy • likelihood ratios • logit • predictive values • sensitivity • specificity


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Med Decis MakingHome page
R. L. Winkler and J. E. Smith
On Uncertainty in Medical Testing
Med Decis Making, November 1, 2004; 24(6): 654 - 658.
[Abstract] [PDF]