Decision Analysis for the Evaluation of Diagnostic Tests, Prediction Models, and Molecular Markers

被引:103
作者
Vickers, Andrew J. [1 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10065 USA
关键词
Decision support techniques; Outcome assessment; Prognosis;
D O I
10.1198/000313008X370302
中图分类号
O21 [概率论与数理统计]; C8 [统计学];
学科分类号
020208 ; 070103 ; 0714 ;
摘要
The traditional statistical approach to the evaluation of diagnostic tests, prediction models, and molecular markers is to assess their accuracy, using metrics such as sensitivity, specificity, and the receiver-operating-characteristic curve. However, there is no obvious association between accuracy and clinical value: it is unclear, for example, just how accurate a test needs to be in order for it to be considered "accurate enough" to warrant its use in patient care. Decision analysis aims to assess the clinical value of a test by assigning weights to each possible consequence. These methods have been historically considered unattractive to the practicing. biostatistician because additional data from the literature, or subjective assessments from individual patients or clinicians, are needed in order to assign weights appropriately. Decision analytic methods are available that can reduce these additional requirements. These methods can provide insight into the consequences of using a test, model, or marker in clinical practice.
引用
收藏
页码:314 / 320
页数:7
相关论文
共 12 条
[1]  
BAKER SG, 2007, AM STAT, V6, P1
[2]  
Berry DA, 1998, CURRENT TOPICS ON BRCA1, P115, DOI 10.3233/BD-1998-101-213
[3]  
Hunink MG, 2001, DECISION MAKING HLTH
[4]   Systematic review: Gene expression profiling assays in early-stage breast cancer [J].
Marchionni, Luigi ;
Wilson, Renee F. ;
Wolff, Antonio C. ;
Marinopoulos, Spyridon ;
Parmigiani, Giovanni ;
Bass, Eric B. ;
Goodman, Steven N. .
ANNALS OF INTERNAL MEDICINE, 2008, 148 (05) :358-W81
[5]   THE THRESHOLD APPROACH TO CLINICAL DECISION-MAKING [J].
PAUKER, SG ;
KASSIRER, JP .
NEW ENGLAND JOURNAL OF MEDICINE, 1980, 302 (20) :1109-1117
[6]   Use of prostate-specific antigen (PSA) isoforms for the detection of prostate cancer in men with a PSA level of 2-10 ng/ml: Systematic review and meta-analysis [J].
Roddam, AW ;
Duffy, MJ ;
Hamdy, FC ;
Ward, AM ;
Patnick, J ;
Price, CP ;
Rimmer, J ;
Sturgeon, C ;
White, P ;
Allen, NE .
EUROPEAN UROLOGY, 2005, 48 (03) :386-399
[7]   The story of the European Randomized study of screening for prostate cancer [J].
Schröder, FH ;
Denis, LJ ;
Roobol, M .
BJU INTERNATIONAL, 2003, 92 :1-13
[8]  
SKATES SJ, 1995, CANCER, V76, P2004, DOI 10.1002/1097-0142(19951115)76:10+<2004::AID-CNCR2820761317>3.0.CO
[9]  
2-G
[10]  
Vergouwe Yvonne, 2002, Semin Urol Oncol, V20, P96, DOI 10.1053/suro.2002.32521