Assessing Diagnostic Tests: How to Correct for the Combined Effects of Interpretation and Reference Standard

Ahmet Omurtag, Andre A. Fenton

Research output: Contribution to journalArticle

Abstract

We describe a general solution to the problem of determining diagnostic accuracy without the use of a perfect reference standard and in the presence of interpreter variability. The accuracy of a diagnostic test is typically determined by comparing its outcomes with those of an established reference standard. But the accuracy of the standard itself and those of the interpreters strongly influence such assessments. We use our solution to examine the effects of the properties of the standard, the reliability of the interpreters, and the prevalence of abnormality on the measured sensitivity and specificity. Our results provide a method of systematically adjusting the measured sensitivity and specificity in order to estimate their true values. The results are validated by simulations and their detailed application to specific cases are described.

Original languageEnglish (US)
Article numbere52221
JournalPloS one
Volume7
Issue number12
DOIs
StatePublished - Dec 29 2012

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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