Greenes R A, Cain K C, Begg C B
Med Decis Making. 1984;4(1):7-15. doi: 10.1177/0272989X8400400103.
Prospective assessment of a test for possible use in evaluation of a patient ideally should be based on the test's ability to affect subsequent patient management beneficially, in relation to both the costs of the test itself and the costs of misclassification of disease status. This requires specification of the costs and benefits of subsequent actions and the cost of the test, estimation of the probability of disease, knowledge of the discriminatory properties of the test, and formal decision analysis. Often, however, the physician has less complete information with which to make a test order decision. A spectrum of performance measures exists for characterising a diagnostic test, ranging from measures that are largely patient-independent to measures that are highly patient-dependent. Two measures from the patient-dependent part of the spectrum, Assignment Potential and Assignment Strength, can be useful in decision making when formal decision analysis is not feasible. A third measure, the U-Factor, is the product of the other two, and is a computational tool that facilitates formal decision analysis.
对一项可能用于评估患者的检测进行前瞻性评估，理想情况下应基于该检测在影响后续患者管理方面的有益能力，这涉及检测本身的成本以及疾病状态误分类的成本。这需要明确后续行动的成本和收益以及检测的成本，估计疾病的概率，了解检测的鉴别特性，以及进行正式的决策分析。然而，医生往往缺乏足够完整的信息来做出检测医嘱决策。存在一系列用于表征诊断检测的性能指标，范围从很大程度上与患者无关的指标到高度依赖患者的指标。在正式决策分析不可行时，来自该指标范围中依赖患者部分的两个指标，即分配潜力和分配强度，在决策中可能会有用。第三个指标，U因子，是其他两个指标的乘积，是一种便于进行正式决策分析的计算工具。
