Richter K, Abel U, Klar R, Köbberling J, Trampisch H J, Windeler J
Medizinische Klinik, Ferdinand-Sauerbruch-Klinikum, Wuppertal.
Klin Wochenschr. 1988 Aug 1;66(15):655-61. doi: 10.1007/BF01726922.
The fundamental terms in the evaluation of diagnostic tests are described and the differences to corresponding test parameters in clinical chemistry are emphasized. The derivation of a two-by two contingency table is explained in detail and basic characteristics of diagnostic tests, i.e. sensitivity and specificity as well as their independence of the prevalence (in the sense of a-priori-probability) is pointed out. The importance of the so-called predictive values is shown graphically, also the problem of selecting a cut-off-level (discrimination value) for the evaluation of quantitative data. The various attempts to find a single value for the description of a diagnostic test are discussed and it is stressed that there is no principal necessity to use other terms than those mentioned above. Nevertheless it is possible to give a prevalence-independent measure which has some additional advantages in rating and comparing simple diagnostic tests.
文中描述了诊断试验评估中的基本术语，并强调了与临床化学中相应试验参数的差异。详细解释了二乘二列联表的推导过程，并指出了诊断试验的基本特征，即敏感性和特异性，以及它们与患病率（在先验概率意义上）的独立性。以图形方式展示了所谓预测值的重要性，以及为评估定量数据选择临界值（判别值）的问题。讨论了寻找单一值来描述诊断试验的各种尝试，并强调除上述术语外，原则上没有必要使用其他术语。然而，有可能给出一种与患病率无关的测量方法，它在评估和比较简单诊断试验方面具有一些额外的优势。
