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Determination of the Optimal Cutoff Point using Adjusted Stratum-Specific Likelihood Ratios when Disease Verification is subject to Verification Bias

선택편향이 존재할 때, 수정 층화우도비를 이용한 최적절사점의 결정

  • Kim, Hu-Nam (Department of Biostatistics, The Catholic University of Korea) ;
  • Park, Yong-Gyu (Department of Biostatistics, The Catholic University of Korea)
  • 김후남 (가톨릭대학교 대학원 의학통계학과) ;
  • 박용규 (가톨릭대학교 대학원 의학통계학과)
  • Published : 2007.11.30

Abstract

Stratum-specific likelihood ratio, which is ratio of the sensitivity to 1-the specificity in each stratum of the test, could be biased if the sensitivity and specificity of diagnostic test are affected by verification bias. Therefore, the optimal cutoff point determined by biased stratum-specific likelihood ratios is incorrect. In this study, we derived adjusted stratum-specific likelihood ratios using the adjusted sensitivity and specificity, and obtained the adjusted optimal cutoff point. The influence of the verification bias on the optimal cutoff point was described through the relation between adjusted and unadjusted stratum-specific likelihood ratios.

진단검사에서 민감도와 특이도가 선택편향에 영향을 받을 때, 진단검사의 각층에서의 민감도와 1-특이도의 비로 얻어지는 층화우도비도 편의가 존재하게 된다. 따라서 편의가 있는 층화우도비로 찾아진 최적절사점도 잘못된 값이 된다. 본 연구에서는 Begg과 Greenes (1983)에 의해 제안된 수정 민감도와 특이도를 층화우도비에 적용하여, 선택편향이 수정되는 최적절사점을 찾아보았다. 그리고 선택편향이 최적절사점에 미치는 영향을 선택편향 수정인자를 통해 설명하였다.

Keywords

References

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