Estimating confidence intervals for the difference in diagnostic accuracy with three ordinal diagnostic categories without a gold standard.

ABSTRACT: With three ordinal diagnostic categories, the most commonly used measures for the overall diagnostic accuracy are the volume under the ROC surface (VUS) and partial volume under the ROC surface (PVUS), which are the extensions of the area under the ROC curve (AUC) and partial area under the ROC curve (PAUC), respectively. A gold standard (GS) test on the true disease status is required to estimate the VUS and PVUS. However, oftentimes it may be difficult, inappropriate, or impossible to have a GS because of misclassification error, risk to the subjects or ethical concerns. Therefore, in many medical research studies, the true disease status may remain unobservable. Under the normality assumption, a maximum likelihood (ML) based approach using the expectation-maximization (EM) algorithm for

SUBMITTER: Kang L 

PROVIDER: S-EPMC3883051 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature