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A New Statistical Taguchi Approach for Determining the Diagnostic Accuracy of the Cage Questionnaire

Year 2002, Volume: 1 Issue: 2, 85 - 94, 16.08.2002

Abstract

The CAGE Questionnaire is a sensitive and specific tool for screening alcoholism that can be practically used by physicians in wide range of patient profiles under different treatment settings. However, the diagnostic accuracy of CAGE, although assumed to be high, is yet unknown. If its being high is determined statistically in absolute terms, then it will be proven that the CAGE does offer the promise of raising the identification rate of alcoholic patients substantially. This article aims to determine the diagnostic accuracy of CAGE in different patient profiles by Taguchi's signal-to-noise (S/N) ratios. The proposed method can also be used for determining the diagnostic superiority among the analyses that give seemingly undifferentiable Receiver Operating Characteristic (ROC) curves or ROC areas (AUC).

References

  • ALVAREZ F.J. DEL RIO M.C (1994), “Screening for Problem Drinkers in a General Population Survey in Spain by Use of the CAGE Scale”, Journal of Studies on Alcohol, 55, 471-474.
  • AMERICAN PSYCHIATRIC ASSOCIATION (1987), Diagnostic and Statistical Manual of Mental Disorders. Rev., 3rd edition, Washington, D.C.
  • BUCHSBAUM D.G, BUCHANAN R.G, CENTOR R.M (1991), “Screening for Alcohol Abuse Using CAGE Scores and Likelihood Ratios”, Annals of Internal Medicine, 115, 774-777.
  • BUCHSBAUM D.G., BUCHANAN R.G, WELSH J. (1992), “ Screening for Drinking Disorders in the Elderly Using the CAGE Questionnaire”, Journal of American Geriatrics Society, 40, 662-665.
  • BUSH B., SHAW S., CLEARLY P. (1987), “Screening for Alcohol Abuse Using the CAGE Questionaire”, American Journal of Medicine, 82, 231-235.
  • CABALLERO L., CABALLERO F. SANTO-DOMINGO J. (1989), “CAGE: Differences between Males and Females”, British Journal of Addiction, 8, 700-701.
  • DEHNAD K. (1989), Quality Control, Robust Design, and the Taguchi Method, California: Wadsworth & Brooks/Cole Press.
  • EWING J.A., ROUSE B.A. (1970), Identifying the Hidden Alcoholic, 29th İnternational Congress on Alcohol and Drug Dependence, Sydney, Australia.
  • GIRELA E., VILLANUEVA E., HERNANDEZ-CUETO C. (1994), “Comparisons of the CAGE Questionaire versus some Biochemical Markers in the Diagnosis of Alcoholism”, Alcohol Alcholism, 29, 337-343.
  • HANLEY J.A., MCNEIL B.J. (1982), “The Meaning and Use of the Area under a Receiver Operating Characteristic Curve”, Radiology, 143, 29-36.
  • HAYS R.D., HILL L., GILLOGLY J.J. (1993),”Response Times for the CAGE, MAST, TWEAK, and Jellineck Alcohol Scales”, Behavior Research Methods Instruments and Computers, 25, 304-307.
  • MAYFIELD D., MCLEOD G., HALL P. (1974), “The CAGE Questionnaire: Validation of a New Alcoholism Screening Instrument”, American Journal of Psychiatry, 131, 1121-1123.
  • MURRAY M., MCMILLAN C. (1993),”Problem Drinking in Northern Ireland: Results of a Community Survey Using the CAGE Questionnaire”, Alcohol Alcoholism, 28, 477-483.
  • NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (1995), The Physicians’ Guide to Helping Patients with Alcohol Problem, U.S. Department of Health and Human Services, Public Health Services, Bethesda, MD.
  • NIVEN RG (1984), “Alcholism-A Problem in Perspective”, Journal of the American Medical Association, 252, 1912-1914.
  • NYSTROM M., PERASALO J., SALASPURO M. (1993), “Screening for Heavy Drinking and Alcohol-Related Problems in University Students, Journal of Studies on Alcohol, 54, 528-533.
  • POULIN C., WEBSTER I., SINGLE, E. (1997) “Alcohol Disorders in Canada as Indicated by the CAGE Questionnaire”, Journal of Canadian Medical Association, 157, 1529-1535.
  • ROBINS L.N, HELZER J.E, CROUGHAN J. (1981), “Natıonal Institute of Mental Health Diagnostic Interview Schedule: Its History, Characteristics and Validity”, Archives of General Psychiatry, 38, 381-389.
  • TANER M.T, ANTONY J. (2000), “The Assesment of Quality in Medical Diagnostic Tests: A Comparison of ROC/Youden And Taguchi Methods”, International Journal of Health Care Quality Assurance, 13, 300-307.
  • TANER M.T., GÜVENİŞ, A. (2001),”A Statistical Assessment of Alcohol Abuse by Average Loss Curves”, İkinci İstatistik Kongresi, İstatistik Mezunları Derneği, Antalya, 333-338.

Cage Anketinin Tanısal Doğruluğunun Belirlenmesi İçin Yeni Bir İstatistiksel Taguchi Yaklaşımı

Year 2002, Volume: 1 Issue: 2, 85 - 94, 16.08.2002

Abstract

CAGE anketi, geniş bir hasta profilinde farklı tedavi yöntemlerini içine alacak şekilde hekimlerin sistematik bir şekilde alkolizmin teşhisine yönelik kolayca kullanabildikleri, tanısal doğruluğu yüksek olduğu tahmin edilen ancak henüz tam anlamıyla belirlenememiş, yüksek özgüllük ve duyarlılık değerleri olan bir analizdir. CAGE anketinin tanısal doğruluğunun istatistiksel bir yöntem vasıtasıyla kesin olarak belirlenmesi, bu anketin alkolik bireylerin tanımlanma oranlarını önemli derecede yükselttiğine dair bir ispat niteliğinde olacağından büyük bir öneme haizdir. Bu makalede, Taguchi Yöntemlerinin bir parçası olarak önerilen sinyal-gürültü oranları (S/N) vasıtasıyla, CAGE anketinin tanısal doğruluğunun değişik hasta profillerinde tespit edilip sunulması amaçlanmaktadır. Önerilen bu yeni yöntem, birbirine çok yakın değerler taşıyan Nisbi İşlemleme Özelliği Eğrileri (ROC) ve bu eğrilerin altında kalan alanları (AUC) veren analizlerde tanısal üstünlük tayini için de kullanılabilir.

References

  • ALVAREZ F.J. DEL RIO M.C (1994), “Screening for Problem Drinkers in a General Population Survey in Spain by Use of the CAGE Scale”, Journal of Studies on Alcohol, 55, 471-474.
  • AMERICAN PSYCHIATRIC ASSOCIATION (1987), Diagnostic and Statistical Manual of Mental Disorders. Rev., 3rd edition, Washington, D.C.
  • BUCHSBAUM D.G, BUCHANAN R.G, CENTOR R.M (1991), “Screening for Alcohol Abuse Using CAGE Scores and Likelihood Ratios”, Annals of Internal Medicine, 115, 774-777.
  • BUCHSBAUM D.G., BUCHANAN R.G, WELSH J. (1992), “ Screening for Drinking Disorders in the Elderly Using the CAGE Questionnaire”, Journal of American Geriatrics Society, 40, 662-665.
  • BUSH B., SHAW S., CLEARLY P. (1987), “Screening for Alcohol Abuse Using the CAGE Questionaire”, American Journal of Medicine, 82, 231-235.
  • CABALLERO L., CABALLERO F. SANTO-DOMINGO J. (1989), “CAGE: Differences between Males and Females”, British Journal of Addiction, 8, 700-701.
  • DEHNAD K. (1989), Quality Control, Robust Design, and the Taguchi Method, California: Wadsworth & Brooks/Cole Press.
  • EWING J.A., ROUSE B.A. (1970), Identifying the Hidden Alcoholic, 29th İnternational Congress on Alcohol and Drug Dependence, Sydney, Australia.
  • GIRELA E., VILLANUEVA E., HERNANDEZ-CUETO C. (1994), “Comparisons of the CAGE Questionaire versus some Biochemical Markers in the Diagnosis of Alcoholism”, Alcohol Alcholism, 29, 337-343.
  • HANLEY J.A., MCNEIL B.J. (1982), “The Meaning and Use of the Area under a Receiver Operating Characteristic Curve”, Radiology, 143, 29-36.
  • HAYS R.D., HILL L., GILLOGLY J.J. (1993),”Response Times for the CAGE, MAST, TWEAK, and Jellineck Alcohol Scales”, Behavior Research Methods Instruments and Computers, 25, 304-307.
  • MAYFIELD D., MCLEOD G., HALL P. (1974), “The CAGE Questionnaire: Validation of a New Alcoholism Screening Instrument”, American Journal of Psychiatry, 131, 1121-1123.
  • MURRAY M., MCMILLAN C. (1993),”Problem Drinking in Northern Ireland: Results of a Community Survey Using the CAGE Questionnaire”, Alcohol Alcoholism, 28, 477-483.
  • NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (1995), The Physicians’ Guide to Helping Patients with Alcohol Problem, U.S. Department of Health and Human Services, Public Health Services, Bethesda, MD.
  • NIVEN RG (1984), “Alcholism-A Problem in Perspective”, Journal of the American Medical Association, 252, 1912-1914.
  • NYSTROM M., PERASALO J., SALASPURO M. (1993), “Screening for Heavy Drinking and Alcohol-Related Problems in University Students, Journal of Studies on Alcohol, 54, 528-533.
  • POULIN C., WEBSTER I., SINGLE, E. (1997) “Alcohol Disorders in Canada as Indicated by the CAGE Questionnaire”, Journal of Canadian Medical Association, 157, 1529-1535.
  • ROBINS L.N, HELZER J.E, CROUGHAN J. (1981), “Natıonal Institute of Mental Health Diagnostic Interview Schedule: Its History, Characteristics and Validity”, Archives of General Psychiatry, 38, 381-389.
  • TANER M.T, ANTONY J. (2000), “The Assesment of Quality in Medical Diagnostic Tests: A Comparison of ROC/Youden And Taguchi Methods”, International Journal of Health Care Quality Assurance, 13, 300-307.
  • TANER M.T., GÜVENİŞ, A. (2001),”A Statistical Assessment of Alcohol Abuse by Average Loss Curves”, İkinci İstatistik Kongresi, İstatistik Mezunları Derneği, Antalya, 333-338.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Biostatistics
Journal Section Research Articles
Authors

Mehmet Tolga Taner

Publication Date August 16, 2002
Published in Issue Year 2002 Volume: 1 Issue: 2

Cite

APA Taner, M. T. (2002). Cage Anketinin Tanısal Doğruluğunun Belirlenmesi İçin Yeni Bir İstatistiksel Taguchi Yaklaşımı. İstatistik Araştırma Dergisi, 1(2), 85-94.