Arifin Wan Nor, Yusof Umi Kalsom
School of Computer Sciences, Universiti Sains Malaysia, Gelugor 11800, Pulau Pinang, Malaysia.
Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
Diagnostics (Basel). 2022 Nov 17;12(11):2839. doi: 10.3390/diagnostics12112839.
In medical care, it is important to evaluate any new diagnostic test in the form of diagnostic accuracy studies. These new tests are compared to gold standard tests, where the performance of binary diagnostic tests is usually measured by sensitivity (Sn) and specificity (Sp). However, these accuracy measures are often biased owing to selective verification of the patients, known as partial verification bias (PVB). Inverse probability bootstrap (IPB) sampling is a general method to correct sampling bias in model-based analysis and produces debiased data for analysis. However, its utility in PVB correction has not been investigated before. The objective of this study was to investigate IPB in the context of PVB correction under the missing-at-random assumption for binary diagnostic tests. IPB was adapted for PVB correction, and tested and compared with existing methods using simulated and clinical data sets. The results indicated that IPB is accurate for Sn and Sp estimation as it showed low bias. However, IPB was less precise than existing methods as indicated by the higher standard error (SE). Despite this issue, it is recommended to use IPB when subsequent analysis with full data analytic methods is expected. Further studies must be conducted to reduce the SE.
在医疗保健中,以诊断准确性研究的形式评估任何新的诊断测试非常重要。这些新测试与金标准测试进行比较,二元诊断测试的性能通常通过灵敏度(Sn)和特异性(Sp)来衡量。然而,由于对患者的选择性验证,即所谓的部分验证偏倚(PVB),这些准确性测量往往存在偏差。逆概率引导(IPB)抽样是一种在基于模型的分析中校正抽样偏差的通用方法,并产生去偏数据用于分析。然而,其在PVB校正中的效用此前尚未得到研究。本研究的目的是在二元诊断测试的随机缺失假设下,研究PVB校正背景下的IPB。IPB被应用于PVB校正,并使用模拟和临床数据集与现有方法进行测试和比较。结果表明,IPB在Sn和Sp估计方面是准确的,因为它显示出低偏差。然而,如较高的标准误差(SE)所示,IPB的精度低于现有方法。尽管存在这个问题,但如果期望使用完整数据分析方法进行后续分析,建议使用IPB。必须进行进一步的研究以降低标准误差。