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http://dx.doi.org/10.5351/KJAS.2007.20.3.515

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

Kim, Hu-Nam (Department of Biostatistics, The Catholic University of Korea)
Park, Yong-Gyu (Department of Biostatistics, The Catholic University of Korea)
Publication Information
The Korean Journal of Applied Statistics / v.20, no.3, 2007 , pp. 515-530 More about this Journal
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.
Keywords
Verification bias; stratum-specific likelihood ratios; optimal cutoff point;
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