Statistical Evaluation Of Diagnostic Performance

Statistical evaluation of diagnostic performance in general and Receiver Operating Characteristic (ROC) analysis in particular are important for assessing the performance of medical tests and statistical classifiers, as well as for evaluating predictive models or algorithms. This book presents innovative approaches in ROC analysis, which are relevant to a wide variety of applications, including medical imaging, cancer research, epidemiology, and bioinformatics. Statistical Evaluation of Diagnostic Performance: Topics in ROC Analysis covers areas including monotone-transformation techniques in parametric ROC analysis, ROC methods for combined and pooled biomarkers, Bayesian hierarchical transformation models, sequential designs and inferences in the ROC setting, predictive modeling, multireader ROC analysis, and free-response ROC (FROC) methodology. The book is suitable for graduate-level students and researchers in statistics, biostatistics, epidemiology, public health, biomedical engineering, radiology, medical imaging, biomedical informatics, and other closely related fields. Additionally, clinical researchers and practicing statisticians in academia, industry, and government could benefit from the presentation of such important and yet frequently overlooked topics.

This book describes statistical techniques for the design and evaluation of research studies on medical diagnostic tests, screening tests, biomarkers and new technologies for classification and prediction in medicine.

The outlook for women with breast cancer has improved in recent years. Due to the combination of improved treatments and the benefits of mammography screening, breast cancer mortality has decreased steadily since 1989. Yet breast cancer remains a major problem, second only to lung cancer as a leading cause of death from cancer for women. To date, no means to prevent breast cancer has been discovered and experience has shown that treatments are most effective when a cancer is detected early, before it has spread to other tissues. These two facts suggest that the most effective way to continue reducing the death toll from breast cancer is improved early detection and diagnosis. Building on the 2001 report Mammography and Beyond, this new book not only examines ways to improve implementation and use of new and current breast cancer detection technologies but also evaluates the need to develop tools that identify women who would benefit most from early detection screening. Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis encourages more research that integrates the development, validation, and analysis of the types of technologies in clinical practice that promote improved risk identification techniques. In this way, methods and technologies that improve detection and diagnosis can be more effectively developed and implemented.

Technology assessment can lead to the rapid application of essential diagnostic technologies and prevent the wide diffusion of marginally useful methods. In both of these ways, it can increase quality of care and decrease the cost of health care. This comprehensive monograph carefully explores methods of and barriers to diagnostic technology assessment and describes both the rationale and the guidelines for meaningful evaluation. While proposing a multi-institutional approach, it emphasizes some of the problems involved and defines a mechanism for improving the evaluation and use of medical technology and essential resources needed to enhance patient care.

Praise for the First Edition " . . . the book is a valuable addition to the literature in thefield, serving as a much-needed guide for both clinicians andadvanced students."—Zentralblatt MATH A new edition of the cutting-edge guide to diagnostic tests inmedical research In recent years, a considerable amount of research has focusedon evolving methods for designing and analyzing diagnostic accuracystudies. Statistical Methods in Diagnostic Medicine, Second Editioncontinues to provide a comprehensive approach to the topic, guidingreaders through the necessary practices for understanding thesestudies and generalizing the results to patient populations. Following a basic introduction to measuring test accuracy andstudy design, the authors successfully define various measures ofdiagnostic accuracy, describe strategies for designing diagnosticaccuracy studies, and present key statistical methods forestimating and comparing test accuracy. Topics new to the SecondEdition include: Methods for tests designed to detect and locate lesions Recommendations for covariate-adjustment Methods for estimating and comparing predictive values andsample size calculations Correcting techniques for verification and imperfect standardbiases Sample size calculation for multiple reader studies when pilotdata are available Updated meta-analysis methods, now incorporating randomeffects Three case studies thoroughly showcase some of the questions andstatistical issues that arise in diagnostic medicine, with allassociated data provided in detailed appendices. A related web sitefeatures Fortran, SAS®, and R software packages so thatreaders can conduct their own analyses. Statistical Methods in Diagnostic Medicine, Second Edition is anexcellent supplement for biostatistics courses at the graduatelevel. It also serves as a valuable reference for clinicians andresearchers working in the fields of medicine, epidemiology, andbiostatistics.

This book is the first exclusively devoted to the systematic synthesis of diagnostic test accuracy studies. It builds upon the major recent developments in reporting standards, search methods, and, in particular, statistical tools specifically devoted to diagnostic studies. In addition, it borrows extensively from the latest advances in systematic reviews and meta-analyses of intervention studies. After a section dedicated to methods for designing reviews, synthesizing evidence and appraising inconsistency in research, the application of these approaches is demonstrated in the context of case studies from various clinical disciplines. Diagnosis is central in medical decision-making, and in many other fields of human endeavor, such as education and psychology. The plurality of sources of evidence on diagnostic test accuracy poses a huge challenge for practitioners and researchers, as do the multiple dimensions of evidence validity, which include sensitivity, specificity, predictive values, and likelihood ratios. This book offers an invaluable resource for anyone aiming to improve decision-making processes in diagnosis, classification or risk prognostication, from epidemiologists to biostatisticians, radiologists, laboratory physicians and graduate students, as any physician interested in refining his methodological skills in clinical diagnosis.

Evaluation of Diagnostic Systems: Methods from Signal Detection Theory addresses the many issues that arise in evaluating the performance of a diagnostic system, across the wide range of settings in which such systems are used. These settings include clinical medicine, industrial quality control, environmental monitoring and investigation, machine and metals inspection, military monitoring, information retrieval, and crime investigation. The book is divided into three parts encompassing 11 chapters that emphasize the interpretation of diagnostic visual images by human observers. The first part of the book describes quantitative methods for measuring the accuracy of a system and the statistical techniques for drawing inferences from performance tests. The subsequent part covers study design and includes a detailed description of the form and conduct of an image-interpretation test. The concluding part examines the case study of a medical imaging system that serves as an example of both simple and complex applications. In this part, three mammographic modalities are used: industrial film radiography, low-dose film radiography, and xeroradiography. The case study focuses on the overall reliability of accuracy indices made by its main components, that is, the variabilities across cases, across readers, and within individual readers. The supplementary texts provide study protocols, a computer program for processing test results, and an extensive list of references that will assist the reader in applying those evaluative methods to diagnostic systems in any setting. This book is of value to scientists and engineers, as well as to applied, quantitative, or experimental psychologists who are engaged in the study of the human processes of discrimination and decision making in either perceptual or cognitive tasks.

The aim of this book is to present statistical problems and methods in a friendly way to radiologists, emphasizing statistical issues and methods most frequently used in radiological studies (e.g., nonparametric tests, analysis of intra- and interobserver reproducibility, comparison of sensitivity and specificity among different imaging modality, difference between clinical and screening application of diagnostic tests, ect.). The tests will be presented starting from a radiological "problem" and all examples of statistical methods applications will be "radiological".