Zou K H
Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass, USA.
Acad Radiol. 2001 Mar;8(3):225-33. doi: 10.1016/S1076-6332(03)80531-7.
It is common to administer the same diagnostic test more than once to the same set of patients. The purpose of this study was to develop two statistical methods for estimating and comparing correlated receiver operating characteristic (ROC) curves for data derived from repeated diagnostic tests.
Parametric and semiparametric transformation models were developed. These estimation methods were illustrated with data from 72 pigmented lesions suspected of being malignant melanoma. A diagnostic scoring system based on asymmetry, border irregularity, color variation, and diameter was used repeatedly, with or without a dermoscope. Statistical hypothesis tests were conducted to evaluate whether a dermoscope improved the clarity of the lesion features in the scoring system. The resulting ROC curves were constructed, along with characteristics and summary measures.
The areas under the ROC curves were 0.885 (parametric method) and 0.893 (semiparametric method) without the dermoscope, and 0.916 (parametric) and 0.912 (semiparametric) with the dermoscope. The statistical hypothesis tests did not yield statistically significant differences between the underlying ROC curves for either estimation method.
The two transformation models yielded similar results for estimation and comparison of the ROC curves. Although a dermoscope did not add extra information, the scoring system was accurate for diagnosing malignant melanoma.
对同一组患者多次进行相同的诊断测试是很常见的。本研究的目的是开发两种统计方法，用于估计和比较来自重复诊断测试的数据的相关受试者操作特征（ROC）曲线。
开发了参数化和半参数化转换模型。用72个疑似恶性黑色素瘤的色素沉着病变的数据说明了这些估计方法。基于不对称性、边界不规则性、颜色变化和直径的诊断评分系统被反复使用，使用或不使用皮肤镜。进行了统计假设检验，以评估皮肤镜是否提高了评分系统中病变特征的清晰度。构建了所得的ROC曲线，以及特征和汇总指标。
不使用皮肤镜时，ROC曲线下面积分别为0.885（参数化方法）和0.893（半参数化方法），使用皮肤镜时分别为0.916（参数化）和0.912（半参数化）。对于两种估计方法，统计假设检验均未在基础ROC曲线之间产生统计学上的显著差异。
这两种转换模型在ROC曲线的估计和比较中产生了相似的结果。虽然皮肤镜没有增加额外信息，但评分系统对诊断恶性黑色素瘤是准确的。
