Biostatistics, School of Medicine, University of Granada, Granada 18071, Spain.
Stat Med. 2010 Sep 10;29(20):2149-65. doi: 10.1002/sim.3939.
Sensitivity and specificity are classic parameters to assess and compare the performance of binary diagnostic tests versus a gold standard in a population. Another useful parameter to assess and compare the performance of binary tests is the weighted kappa coefficient, which is defined as a measure of the beyond-chance agreement between the diagnostic test and the gold standard. In this study, we deduce the maximum likelihood estimators of the weighted kappa coefficients of multiple binary tests and we propose an asymptotic method to compare the weighted kappa coefficients of multiple binary tests with regard to the same gold standard when all of the diagnostic tests are applied to the same sample of patients. We have carried out simulation experiments to study the type I error and the power of the method that we propose when we compared three binary tests. We have applied the results obtained to the diagnosis of coronary disease.
敏感度和特异性是评估和比较二项诊断测试相对于金标准在人群中的性能的经典参数。另一个有用的参数来评估和比较二项测试的性能是加权kappa 系数,它被定义为诊断测试和金标准之间超出机会一致性的度量。在这项研究中,我们推导出多个二项测试的加权kappa 系数的最大似然估计,并提出了一种渐近方法,当所有的诊断测试都应用于同一批患者时,比较多个二项测试的加权kappa 系数与同一金标准的关系。我们进行了模拟实验,以研究当我们比较三个二项测试时,我们提出的方法的Ⅰ类错误和功效。我们已经将所得结果应用于冠心病的诊断。