Van der Schouw Y T, Verbeek A L, Ruijs J H
Department of Medical Informatics and Epidemiology, University of Nijmegen, The Netherlands.
Fam Pract. 1992 Dec;9(4):506-11. doi: 10.1093/fampra/9.4.506.
New diagnostic tests are mainly evaluated by determining the sensitivity and specificity of the test. These test characteristics were originally meant to be used in making diagnoses. For evaluative purposes their usefulness is weakened by their susceptibility to selection and their dependence on the cut-off points that are used for test positivity. The plotting of a receiver operating characteristic (ROC) curve might be a solution to these problems. Furthermore, the ROC curve yields a measure for the diagnostic power of the test expressed in one number instead of two, namely the area under the curve (AUC). Finally, the ROC curve and its AUC permit easy comparison of different tests and the performance of different interpreters of one test. The construction and use of ROC curves are described and illustrated with data of a case-referent investigation into the relationship between iron status parameters and the presence of acute myocardial infarction. The AUCs of ferritin and serum iron, 0.61 and 0.68 respectively, are too low to suggest meaningful usefulness in clinical practice.
新的诊断测试主要通过确定测试的敏感性和特异性来进行评估。这些测试特征最初旨在用于进行诊断。出于评估目的，它们的有用性因易受选择影响以及对用于测试阳性的临界点的依赖而被削弱。绘制受试者工作特征（ROC）曲线可能是解决这些问题的一种方法。此外，ROC曲线产生了一种用一个数字而非两个数字表示的测试诊断能力的度量，即曲线下面积（AUC）。最后，ROC曲线及其AUC允许轻松比较不同的测试以及同一测试的不同解释者的表现。本文描述并通过一项关于铁状态参数与急性心肌梗死存在之间关系的病例对照研究数据说明了ROC曲线的构建和使用。铁蛋白和血清铁的AUC分别为0.61和0.68，太低以至于在临床实践中无法表明有意义的有用性。
