Hanley J A
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
Crit Rev Diagn Imaging. 1989;29(3):307-35.
Receiver operating characteristic (ROC) methodology has been increasingly used in medical applications in the last 10 years. The text by Swets and Pickett has popularized the technique and the journal Medical Decision Making (1981--) provides a forum for further methodologic issues. In this article, I will (1) describe the nature of the data generated by ROC studies; (2) evaluate the choices of summary indices of performance (accuracy); (3) outline the data-analytic techniques used, and how to incorporate data from multiple observers and multiple "readings"; (4) review proposed alternatives to the commonly used binormal ROC model; and (5) discuss issues, such as verification bias, and challenges, such as multicenter comparative imaging studies and the difficulty of obtaining "truth data", which need to be addressed when adapting ROC methods to medical contexts.
在过去十年中，接受者操作特征（ROC）方法在医学应用中得到了越来越广泛的使用。斯韦茨和皮克特所著的文本使该技术得到了普及，《医学决策》杂志（1981年至今）为进一步探讨方法学问题提供了一个平台。在本文中，我将：（1）描述ROC研究产生的数据的性质；（2）评估性能（准确性）汇总指标的选择；（3）概述所使用的数据分析技术，以及如何纳入来自多个观察者和多次“读数”的数据；（4）回顾针对常用双正态ROC模型提出的替代方案；（5）讨论在将ROC方法应用于医学背景时需要解决的问题，如验证偏倚，以及挑战，如多中心比较成像研究和获取“真实数据”的困难。
