Corrao G, Carle F, Valenti M, Aricò S, Galatola G, Tabone M, Di Orio F
Chair of Medical Statistics, University of L'Aquila, Italy.
Rev Epidemiol Sante Publique. 1993;41(2):123-30.
We assessed the performance of 4 methods of discriminant analysis using as independent variables the age and 16 serum tests, for correctly identifying patients with liver cirrhosis among hospitalized patients affected by chronic liver disease without signs of liver failure; 290 patients entered this study: on the basis of laparoscopy with or without liver biopsy, 152 patients had a diagnosis of liver cirrhosis and 138 were classified as chronic hepatitic patients. Due to the non-multinormal distribution of the variables used and to the unequality of the variance-covariance matrices, we compared the following 4 methods: linear discriminant function, quadratic discriminant function, non-parametric discriminant function and logistic regression. The Receiver Operating Characteristic (ROC) analysis was used to compare diagnostic ability of the assessed methods: the quadratic discriminant function was the best performing method. The predictive ability of this function was compared to that reported for percutaneous liver biopsy, showing that this simple statistical method using age and biochemical tests can efficiently identify liver cirrhosis in the setting of chronic liver disease, reducing the need for invasive diagnostic procedures.
我们评估了4种判别分析方法的性能,将年龄和16项血清检测作为自变量,用于在无肝衰竭迹象的慢性肝病住院患者中正确识别肝硬化患者;290名患者进入本研究:根据有无肝活检的腹腔镜检查结果,152名患者被诊断为肝硬化,138名被归类为慢性肝炎患者。由于所用变量的非多元正态分布以及方差协方差矩阵的不平等,我们比较了以下4种方法:线性判别函数、二次判别函数、非参数判别函数和逻辑回归。采用受试者工作特征(ROC)分析来比较所评估方法的诊断能力:二次判别函数是表现最佳的方法。将该函数的预测能力与经皮肝活检报告的预测能力进行比较,结果表明,这种使用年龄和生化检测的简单统计方法能够在慢性肝病情况下有效识别肝硬化,减少对侵入性诊断程序的需求。