Elbers A R W, Bouma A, Stegeman J A
Epidemiology Unit, Animal Health Service, P.O. Box 9, 7400 AA Deventer, The Netherlands.
Vet Microbiol. 2002 Apr 2;85(4):323-32. doi: 10.1016/s0378-1135(01)00519-3.
The performance of clinical signs as a diagnostic test for the detection of classical swine fever (CSF) outbreaks during the 1997-1998 CSF epidemic in The Netherlands was evaluated by constructing and analysing a receiver operating characteristic (ROC) curve. This curve assesses the discriminating ability of a diagnostic test over a range of test signals. The cut-off values for a defined diagnostic test to detect CSF outbreaks were set by different combinations of clinical signs observed. The area under the ROC curve, which is a quantitative measure of test performance, was significantly (P<0.001) larger than the area under the random ROC curve. This indicates that clinical signs have a significantly higher performance as a diagnostic test for the detection of CSF than for flipping a coin. However, the gain in diagnostic performance compared to a random process is not as much as we would wish it to be. The optimal efficient diagnostic test combined a sensitivity of 72.7% with a specificity of 52.7%, with a combination of the following clinical signs: unsteady gait/ataxia, not eating, not reacting to antibiotic treatment, conjunctivitis, hard faecal pellets.
通过构建和分析受试者工作特征（ROC）曲线，对1997 - 1998年荷兰古典猪瘟（CSF）疫情期间临床症状作为检测CSF疫情诊断试验的性能进行了评估。该曲线评估了诊断试验在一系列测试信号上的鉴别能力。通过观察到的不同临床症状组合，设定了用于检测CSF疫情的特定诊断试验的临界值。ROC曲线下面积是测试性能的定量指标，其显著（P<0.001）大于随机ROC曲线下面积。这表明，作为检测CSF的诊断试验，临床症状的性能显著高于抛硬币。然而，与随机过程相比，诊断性能的提升并不如我们所愿。最佳有效诊断试验结合了72.7%的敏感性和52.7%的特异性，其临床症状组合为：步态不稳/共济失调、不进食、对抗生素治疗无反应、结膜炎、硬粪粒。
