Begg C B
Department of Biostatistics, Harvard University, Boston, Massachusetts.
Crit Rev Med Inform. 1986;1(1):1-22.
A review of statistical methods in medical diagnosis is presented. Research has focused on three distinct tasks: classification of subjects into probable diagnostic categories on the basis of presenting clinical indicators (discriminant analysis), assessment of diagnostic test characteristics, and relation of diagnostic testing to subsequent patient management. Although many sophisticated models have been developed for discriminant analysis, recent empirical comparisons indicate that standard methods such as linear discrimination and logistic regression work very well. More research is needed to overcome practical difficulties that are not accommodated in the conventional assumptions. Research on the assessment of diagnostic tests has been oriented more toward selection biases and practical problems. There is a need to develop generalized models for the problem of differential diagnosis. The relation of testing to subsequent management of the patient is a topic that has only recently been explored. It represents an important task in the cost-effective management of health resources.
本文对医学诊断中的统计方法进行了综述。研究集中在三个不同的任务上：根据呈现的临床指标将受试者分类到可能的诊断类别中（判别分析）、评估诊断测试特征，以及诊断测试与后续患者管理的关系。尽管已经为判别分析开发了许多复杂的模型，但最近的实证比较表明，诸如线性判别和逻辑回归等标准方法效果很好。需要更多的研究来克服传统假设中未考虑的实际困难。对诊断测试评估的研究更多地集中在选择偏倚和实际问题上。有必要为鉴别诊断问题开发通用模型。测试与患者后续管理的关系是一个直到最近才被探索的主题。它是卫生资源成本效益管理中的一项重要任务。
