Hermann G A, Sugiura H T, Krumm R P
Arch Pathol Lab Med. 1986 Jan;110(1):21-5.
We compared two versions of a commercial double-site immunoradiometric assay for human thyrotropin, one of them claimed to show superior ability in apportioning euthyroid and hyperthyroid populations. Relative operating characteristic (ROC) analysis permits the calculation of the area under the ROC curve as an unbiased unit measure of diagnostic validity, and also yields an optimal decision point for separating the two populations, based on relative prevalences and locally perceived utilities of test outcomes. We examined 48 hyperthyroid and 50 euthyroid subjects with the original assay and with a later version from the same manufacturer and conclude that the latter demonstrates a small but significant superiority in diagnostic performance throughout the clinical range of interest. Furthermore, peak diagnostic efficacy is attained when the boundary between the two populations is set at 0.3 mIU/L. At this decision point, sensitivity is 58%, specificity is 96%, and the predictive value of a positive test is 75%.
我们比较了两种用于检测人促甲状腺激素的商业双位点免疫放射分析方法，其中一种声称在区分甲状腺功能正常和甲状腺功能亢进人群方面具有卓越能力。相对操作特征（ROC）分析允许计算ROC曲线下面积，作为诊断有效性的无偏单位度量，并且还能根据相对患病率和测试结果在当地的实际效用，得出区分这两个人群的最佳决策点。我们使用原始检测方法和同一制造商的较新版本检测方法，对48名甲状腺功能亢进患者和50名甲状腺功能正常的受试者进行了检测，得出结论：在整个感兴趣的临床范围内，后一种检测方法在诊断性能上显示出虽小但显著的优势。此外，当将两个人群之间的界限设定为0.3 mIU/L时，可达到最高诊断效能。在这个决策点上，灵敏度为58%，特异性为96%，阳性检测的预测值为75%。
