Statistical Combination Schemes of Repeated Diagnostic Test Data

Kelly H. Zou, Jui G. Bhagwat, John A. Carrino

Research output: Contribution to journalArticle

Abstract

Rationale and Objectives: When diagnostic tests are repeated and combined, a number of schemes may be adopted. Guidelines for their interpretations are required. Materials and Methods: Three combination schemes, "and" (A), "or" (O), and "majority" (M), are considered. To evaluate these schemes, dependency by specifying κ values quantifying repeated test agreement was structured. In a pilot study, the combined accuracies of magnetic resonance imaging using six different pulse sequences of medial collateral ligaments of the elbows of 28 cadavers, with eight having lesions artificially created surgically, were examined. Images were evaluated simultaneously by using a five-point ordinal scale. For each pulse sequence, individuals for whom the diagnosis varied from once to three repetitions were considered. Results: Scheme M improves diagnostic accuracy when sensitivity and specificity of a single test exceed 0.5, with maximal improvement at 0.79. Under scheme A, sensitivity decreases to 0.38-0.59. Under scheme O, sensitivity increases to 0.53-0.79. Scheme M yields a small improvement, reaching 0.50-0.71. Under scheme A, specificity increases to 0.95-0.98. Under scheme O, specificity decreases to 0.91-0.98. Scheme M also yields a small improvement, reaching 0.94-0.98. Conclusion: Scheme A is recommended for ruling in diagnoses, scheme O is recommended for ruling out diagnoses, and scheme M is neutral. Consequently, different schemes may be used to optimize the target diagnostic accuracy.

Original languageEnglish (US)
Pages (from-to)566-572
Number of pages7
JournalAcademic Radiology
Volume13
Issue number5
DOIs
StatePublished - Apr 2006
Externally publishedYes

Fingerprint

Routine Diagnostic Tests
Collateral Ligaments
Elbow
Cadaver
Magnetic Resonance Imaging
Guidelines
Sensitivity and Specificity

Keywords

  • κ statistic
  • Elbow ligament
  • magnetic resonance (MR) imaging
  • repeated diagnostic test
  • sensitivity
  • specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Statistical Combination Schemes of Repeated Diagnostic Test Data. / Zou, Kelly H.; Bhagwat, Jui G.; Carrino, John A.

In: Academic Radiology, Vol. 13, No. 5, 04.2006, p. 566-572.

Research output: Contribution to journalArticle

Zou, Kelly H. ; Bhagwat, Jui G. ; Carrino, John A. / Statistical Combination Schemes of Repeated Diagnostic Test Data. In: Academic Radiology. 2006 ; Vol. 13, No. 5. pp. 566-572.
@article{1185c551ebb44636b453310d3129652d,
title = "Statistical Combination Schemes of Repeated Diagnostic Test Data",
abstract = "Rationale and Objectives: When diagnostic tests are repeated and combined, a number of schemes may be adopted. Guidelines for their interpretations are required. Materials and Methods: Three combination schemes, {"}and{"} (A), {"}or{"} (O), and {"}majority{"} (M), are considered. To evaluate these schemes, dependency by specifying κ values quantifying repeated test agreement was structured. In a pilot study, the combined accuracies of magnetic resonance imaging using six different pulse sequences of medial collateral ligaments of the elbows of 28 cadavers, with eight having lesions artificially created surgically, were examined. Images were evaluated simultaneously by using a five-point ordinal scale. For each pulse sequence, individuals for whom the diagnosis varied from once to three repetitions were considered. Results: Scheme M improves diagnostic accuracy when sensitivity and specificity of a single test exceed 0.5, with maximal improvement at 0.79. Under scheme A, sensitivity decreases to 0.38-0.59. Under scheme O, sensitivity increases to 0.53-0.79. Scheme M yields a small improvement, reaching 0.50-0.71. Under scheme A, specificity increases to 0.95-0.98. Under scheme O, specificity decreases to 0.91-0.98. Scheme M also yields a small improvement, reaching 0.94-0.98. Conclusion: Scheme A is recommended for ruling in diagnoses, scheme O is recommended for ruling out diagnoses, and scheme M is neutral. Consequently, different schemes may be used to optimize the target diagnostic accuracy.",
keywords = "κ statistic, Elbow ligament, magnetic resonance (MR) imaging, repeated diagnostic test, sensitivity, specificity",
author = "Zou, {Kelly H.} and Bhagwat, {Jui G.} and Carrino, {John A.}",
year = "2006",
month = "4",
doi = "10.1016/j.acra.2006.01.052",
language = "English (US)",
volume = "13",
pages = "566--572",
journal = "Academic Radiology",
issn = "1076-6332",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - Statistical Combination Schemes of Repeated Diagnostic Test Data

AU - Zou, Kelly H.

AU - Bhagwat, Jui G.

AU - Carrino, John A.

PY - 2006/4

Y1 - 2006/4

N2 - Rationale and Objectives: When diagnostic tests are repeated and combined, a number of schemes may be adopted. Guidelines for their interpretations are required. Materials and Methods: Three combination schemes, "and" (A), "or" (O), and "majority" (M), are considered. To evaluate these schemes, dependency by specifying κ values quantifying repeated test agreement was structured. In a pilot study, the combined accuracies of magnetic resonance imaging using six different pulse sequences of medial collateral ligaments of the elbows of 28 cadavers, with eight having lesions artificially created surgically, were examined. Images were evaluated simultaneously by using a five-point ordinal scale. For each pulse sequence, individuals for whom the diagnosis varied from once to three repetitions were considered. Results: Scheme M improves diagnostic accuracy when sensitivity and specificity of a single test exceed 0.5, with maximal improvement at 0.79. Under scheme A, sensitivity decreases to 0.38-0.59. Under scheme O, sensitivity increases to 0.53-0.79. Scheme M yields a small improvement, reaching 0.50-0.71. Under scheme A, specificity increases to 0.95-0.98. Under scheme O, specificity decreases to 0.91-0.98. Scheme M also yields a small improvement, reaching 0.94-0.98. Conclusion: Scheme A is recommended for ruling in diagnoses, scheme O is recommended for ruling out diagnoses, and scheme M is neutral. Consequently, different schemes may be used to optimize the target diagnostic accuracy.

AB - Rationale and Objectives: When diagnostic tests are repeated and combined, a number of schemes may be adopted. Guidelines for their interpretations are required. Materials and Methods: Three combination schemes, "and" (A), "or" (O), and "majority" (M), are considered. To evaluate these schemes, dependency by specifying κ values quantifying repeated test agreement was structured. In a pilot study, the combined accuracies of magnetic resonance imaging using six different pulse sequences of medial collateral ligaments of the elbows of 28 cadavers, with eight having lesions artificially created surgically, were examined. Images were evaluated simultaneously by using a five-point ordinal scale. For each pulse sequence, individuals for whom the diagnosis varied from once to three repetitions were considered. Results: Scheme M improves diagnostic accuracy when sensitivity and specificity of a single test exceed 0.5, with maximal improvement at 0.79. Under scheme A, sensitivity decreases to 0.38-0.59. Under scheme O, sensitivity increases to 0.53-0.79. Scheme M yields a small improvement, reaching 0.50-0.71. Under scheme A, specificity increases to 0.95-0.98. Under scheme O, specificity decreases to 0.91-0.98. Scheme M also yields a small improvement, reaching 0.94-0.98. Conclusion: Scheme A is recommended for ruling in diagnoses, scheme O is recommended for ruling out diagnoses, and scheme M is neutral. Consequently, different schemes may be used to optimize the target diagnostic accuracy.

KW - κ statistic

KW - Elbow ligament

KW - magnetic resonance (MR) imaging

KW - repeated diagnostic test

KW - sensitivity

KW - specificity

UR - http://www.scopus.com/inward/record.url?scp=33646060365&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646060365&partnerID=8YFLogxK

U2 - 10.1016/j.acra.2006.01.052

DO - 10.1016/j.acra.2006.01.052

M3 - Article

C2 - 16627197

AN - SCOPUS:33646060365

VL - 13

SP - 566

EP - 572

JO - Academic Radiology

JF - Academic Radiology

SN - 1076-6332

IS - 5

ER -