Assessing the Performance of Diagnostic Tests When a Gold Standard Does Not Exist

Yıl 2014, Cilt: 16 Sayı: 2, 58 - 62, 01.07.2014

Gülhan Orekici Temel Semra Erdoğan

Öz

Situations are encountered that gold standard doesn’t exist and two or more imprecise referencetests are available in the diagnosis of a specific disease clinically. There are three basicapproaches including Discrepant Resolution (DR), Composite Reference Standard (CRS) andLatent Class model (LCA) in literature for assessing the performance of diagnostic tests. Thisstudy is aimed to evaluate the three basic approaches. LCA has a more complex structure thanDR and CRS approach. LCA is more advantageous than CRS and DR methods without anyassumptions about resolver test or other imperfect reference tests specify. As a result, LCAmethods which are developed for assessing the performance of new diagnostic test and reducingthe bias because of imperfect reference tests give more reliable results than other methods

Anahtar Kelimeler

Diagnostic test, Composite reference standard, Latent class analysis

ALTIN STANDART TESTİN OLMADIĞI DURUMDA TANI TESTLERİNİN PERFORMANSLARININ DEĞERLENDİRİLMESİ

Öz

Klinikte belirli bir hastalığın tanısının konulmasında, altın standart testin olmadığı ama iki veyadaha fazla kesin olmayan referans testin var olduğu durumlarla karşılaşılmaktadır. Yeni testinkesin olmayan referans testlere göre performanslarını değerlendirmek için literatürde DiscrepantResolution (DR), Composite Referans Standart (CRS) ve Latent Class model (LCA) olmaküzere üç temel yaklaşım bulunmaktadır. Bu çalışma ile üç temel yaklaşımın değerlendirilmesiamaçlanmıştır. LCA, DR ve CRS yaklaşımından çok daha karmaşık bir yapıya sahiptir. LCA,çözücü test ya da diğer bir kesin olmayan referans testin seçiciliği hakkında herhangi birvarsayım gerektirmeksizin CRS ve DR yöntemlerinden daha avantajlıdır. Sonuç olarak, yenitanı testinin performansını değerlendirmek ve kesin olmayan referans testler sonucunda ortayaçıkan yanlılığı azaltmak adına geliştirilen yöntemlerden LCA, diğer yöntemlere nazaran dahagüvenilir sonuçlar vermektedir

Anahtar Kelimeler

Tanı testi, Composite referans standart, Gizli sınıf analizi

Kaynakça

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