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      Medical Diagnostic Tests: A Review of Test Anatomy, Phases, and Statistical Treatment of Data

      review-article
      Computational and Mathematical Methods in Medicine
      Hindawi

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          Abstract

          Diagnostic tests are approaches used in clinical practice to identify with high accuracy the disease of a particular patient and thus to provide early and proper treatment. Reporting high-quality results of diagnostic tests, for both basic and advanced methods, is solely the responsibility of the authors. Despite the existence of recommendation and standards regarding the content or format of statistical aspects, the quality of what and how the statistic is reported when a diagnostic test is assessed varied from excellent to very poor. This article briefly reviews the steps in the evaluation of a diagnostic test from the anatomy, to the role in clinical practice, and to the statistical methods used to show their performances. The statistical approaches are linked with the phase, clinical question, and objective and are accompanied by examples. More details are provided for phase I and II studies while the statistical treatment of phase III and IV is just briefly presented. Several free online resources useful in the calculation of some statistics are also given.

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          Most cited references188

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          Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine.

          The clinical performance of a laboratory test can be described in terms of diagnostic accuracy, or the ability to correctly classify subjects into clinically relevant subgroups. Diagnostic accuracy refers to the quality of the information provided by the classification device and should be distinguished from the usefulness, or actual practical value, of the information. Receiver-operating characteristic (ROC) plots provide a pure index of accuracy by demonstrating the limits of a test's ability to discriminate between alternative states of health over the complete spectrum of operating conditions. Furthermore, ROC plots occupy a central or unifying position in the process of assessing and using diagnostic tools. Once the plot is generated, a user can readily go on to many other activities such as performing quantitative ROC analysis and comparisons of tests, using likelihood ratio to revise the probability of disease in individual subjects, selecting decision thresholds, using logistic-regression analysis, using discriminant-function analysis, or incorporating the tool into a clinical strategy by using decision analysis.
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            A concordance correlation coefficient to evaluate reproducibility.

            L Lin (1989)
            A new reproducibility index is developed and studied. This index is the correlation between the two readings that fall on the 45 degree line through the origin. It is simple to use and possesses desirable properties. The statistical properties of this estimate can be satisfactorily evaluated using an inverse hyperbolic tangent transformation. A Monte Carlo experiment with 5,000 runs was performed to confirm the estimate's validity. An application using actual data is given.
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              Measurement in Medicine: The Analysis of Method Comparison Studies

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                Author and article information

                Contributors
                Journal
                Comput Math Methods Med
                Comput Math Methods Med
                CMMM
                Computational and Mathematical Methods in Medicine
                Hindawi
                1748-670X
                1748-6718
                2019
                28 May 2019
                : 2019
                : 1891569
                Affiliations
                Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania
                Author notes

                Academic Editor: Juan Pablo Martínez

                Author information
                http://orcid.org/0000-0002-2342-4311
                Article
                10.1155/2019/1891569
                6558629
                31275427
                e29c1003-d888-462c-bb5b-f04e4de0d883
                Copyright © 2019 Sorana D. Bolboacă.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 September 2018
                : 25 April 2019
                : 8 May 2019
                Categories
                Review Article

                Applied mathematics
                Applied mathematics

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