Kini Vinay, Ferrari Victor A, Han Yuchi, Jha Saurabh
Division of Cardiovascular Medicine, The Hospital of the University of Pennsylvania, 9021 Gates, 3400 Spruce Street, Philadelphia, PA 19104.
Division of Cardiovascular Medicine, The Hospital of the University of Pennsylvania, 9021 Gates, 3400 Spruce Street, Philadelphia, PA 19104.
Acad Radiol. 2015 Aug;22(8):1016-9. doi: 10.1016/j.acra.2014.11.016. Epub 2015 Mar 18.
Thresholds derived from quantification in imaging are increasingly used to define disease. This derivation is not an exact science. When one uses a threshold to define a disease, one does not clearly demarcate disease from normality because the threshold includes overlapping spectra of mild disease and normality. Thus, use of the threshold will mislabel normal individuals with disease. In this perspective, we will describe how the threshold has been derived for left ventricular noncompaction cardiomyopathy, the statistical biases in the design of studies used to derive the threshold, and the dangers of overdiagnosis when the threshold is used to rule out left ventricular noncompaction cardiomyopathy.
从成像定量得出的阈值越来越多地用于定义疾病。这种推导并非精确的科学。当使用一个阈值来定义一种疾病时，无法明确区分疾病与正常状态，因为该阈值包含了轻度疾病和正常状态的重叠范围。因此，使用该阈值会将正常个体误诊为患有疾病。从这个角度出发，我们将描述左心室致密化不全心肌病阈值是如何得出的，用于推导该阈值的研究设计中的统计偏差，以及当使用该阈值排除左心室致密化不全心肌病时过度诊断的风险。
