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Variability in diagnostic accuracy can be estimated using simple population weighting.

Björk, Jonas LU ; Grubb, Anders LU and Nyman, Ulf LU (2009) In Journal of Clinical Epidemiology 62(1). p.54-57
Abstract
OBJECTIVE: Diagnostic accuracy of a quantitative diagnostic test at a given numeric cutoff is dependent on the type of population (e.g., chronic, referrals, or screening) under investigation. Simple weighted averages calculated from a single study sample may be used to assess variability in accuracy in different types of populations. STUDY DESIGN AND SETTING: We evaluated the accuracy of the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation as a diagnostic test to separate stage 1 and 2 chronic kidney disease (>or=60 mL/min per 1.73 m(2)) from stage 3-5 (<60 mL/min per 1.73 m(2) requiring treatment to prevent progression) in a sample of 850 patients referred for determination of glomerular filtration rate (GFR).... (More)
OBJECTIVE: Diagnostic accuracy of a quantitative diagnostic test at a given numeric cutoff is dependent on the type of population (e.g., chronic, referrals, or screening) under investigation. Simple weighted averages calculated from a single study sample may be used to assess variability in accuracy in different types of populations. STUDY DESIGN AND SETTING: We evaluated the accuracy of the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation as a diagnostic test to separate stage 1 and 2 chronic kidney disease (>or=60 mL/min per 1.73 m(2)) from stage 3-5 (<60 mL/min per 1.73 m(2) requiring treatment to prevent progression) in a sample of 850 patients referred for determination of glomerular filtration rate (GFR). Using population weighting, we also estimated the accuracy of the MDRD equation when the GFR distribution typically found in screening situations was mimicked. RESULTS: Estimated diagnostic accuracy of the MDRD equation varied substantially for different population types (sensitivity range 82%-97%, specificity 67%-93%; figures include the original MDRD study). CONCLUSIONS: Reports of diagnostic accuracy should include estimates of the variability of diagnostic accuracy, using different real or tentative population distributions. Population weighting is a useful tool for this purpose. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Epidemiology
volume
62
issue
1
pages
54 - 57
publisher
Elsevier
external identifiers
  • wos:000262015600008
  • pmid:19095167
  • scopus:57449094788
ISSN
1878-5921
DOI
10.1016/j.jclinepi.2008.09.001
language
English
LU publication?
yes
id
43f105e5-d961-4c1e-97ce-718af5d84f0f (old id 1276079)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19095167?dopt=Abstract
date added to LUP
2009-01-09 12:34:24
date last changed
2017-04-09 04:30:01
@article{43f105e5-d961-4c1e-97ce-718af5d84f0f,
  abstract     = {OBJECTIVE: Diagnostic accuracy of a quantitative diagnostic test at a given numeric cutoff is dependent on the type of population (e.g., chronic, referrals, or screening) under investigation. Simple weighted averages calculated from a single study sample may be used to assess variability in accuracy in different types of populations. STUDY DESIGN AND SETTING: We evaluated the accuracy of the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation as a diagnostic test to separate stage 1 and 2 chronic kidney disease (&gt;or=60 mL/min per 1.73 m(2)) from stage 3-5 (&lt;60 mL/min per 1.73 m(2) requiring treatment to prevent progression) in a sample of 850 patients referred for determination of glomerular filtration rate (GFR). Using population weighting, we also estimated the accuracy of the MDRD equation when the GFR distribution typically found in screening situations was mimicked. RESULTS: Estimated diagnostic accuracy of the MDRD equation varied substantially for different population types (sensitivity range 82%-97%, specificity 67%-93%; figures include the original MDRD study). CONCLUSIONS: Reports of diagnostic accuracy should include estimates of the variability of diagnostic accuracy, using different real or tentative population distributions. Population weighting is a useful tool for this purpose.},
  author       = {Björk, Jonas and Grubb, Anders and Nyman, Ulf},
  issn         = {1878-5921},
  language     = {eng},
  number       = {1},
  pages        = {54--57},
  publisher    = {Elsevier},
  series       = {Journal of Clinical Epidemiology},
  title        = {Variability in diagnostic accuracy can be estimated using simple population weighting.},
  url          = {http://dx.doi.org/10.1016/j.jclinepi.2008.09.001},
  volume       = {62},
  year         = {2009},
}