Abstract:
OBJECTIVES:Many diagnostic studies are aimed at defining "optimal" thresholds. Here, we evaluate the performance of empirically defined optimal thresholds (1) in the sample in which they were defined and (2) in the population from which the sample was drawn. STUDY DESIGN AND SETTING:We simulated test results for 120,000 samples varying the number of people without a disease (n between 20 and 500), number of people with a disease (m between 20 and 500), the magnitude of the difference between group means [effect size (ES) between 0.5 and 4], and distributions (normal and log-normal). The thresholds associated with the maximal Youden index were defined as optimal. Performance was defined as the percentage of correct classifications in the sample and when applied to the whole population. RESULTS:At the population level, the thresholds defined for the four ESs (0.5, 0.8, 2, and 4) yielded a median of 59%, 65%, 83%, and 97% correct classifications, respectively. At the sample level, the samples with similar characteristics yielded widely varying estimates of the performance that were systematically higher than at the population level. CONCLUSION:Researchers need to be careful defining cut points for mean differences that are traditionally considered "large" (ES = 0.8). The diagnostic utility of optimal thresholds needs to be assessed in prospective studies.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Hirschfeld G,do Brasil PEdoi
10.1016/j.jclinepi.2013.07.018subject
Has Abstractpub_date
2014-04-01 00:00:00pages
449-53issue
4eissn
0895-4356issn
1878-5921pii
S0895-4356(13)00348-Xjournal_volume
67pub_type
杂志文章abstract::Accurate prognosis is critical to the design of all prospective research aimed at improving survival. Predictions based on birth weight, gestational age, or any other single variable, fail to take into account the potentially important contribution of other factors. In order to develop a practical and accurate multiva...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章
doi:10.1016/0895-4356(88)90079-0
更新日期:1988-01-01 00:00:00
abstract::The different measurement properties necessary for instruments whose goal is to detect differences between subjects at a single point in time (discriminative instruments) and those whose goal is to detect longitudinal change within subjects (evaluative instruments) is becoming increasingly recognized. Up to now, requi...
journal_title:Journal of clinical epidemiology
pub_type: 评论,杂志文章
doi:10.1016/0895-4356(92)90194-r
更新日期:1992-12-01 00:00:00
abstract::The utility of ordinal logistic regression in the prediction of colorectal neoplasia was demonstrated in a group of 461 consecutive patients undergoing colonoscopy in a community practice. One hundred twenty-nine patients had adenomatous polyps and 34 had colorectal adenocarcinoma. An ordinal logistic regression model...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
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更新日期:1991-01-01 00:00:00
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journal_title:Journal of clinical epidemiology
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journal_title:Journal of clinical epidemiology
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更新日期:2020-11-01 00:00:00
abstract::To identify characteristics of certifying physicians and the deceased that are associated with errors in death certificate completion in Taiwan, we retrospectively reviewed 4123 systematically sampled death certificates issued in 1994. Multivariate analyses were used to assess the associations of various characteristi...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(00)00299-7
更新日期:2001-03-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2017.10.020
更新日期:2018-01-01 00:00:00
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更新日期:2004-06-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
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更新日期:2013-10-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2007.04.003
更新日期:2007-10-01 00:00:00
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更新日期:2011-09-01 00:00:00
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更新日期:2016-11-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0895-4356(93)90143-o
更新日期:1993-12-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(96)00116-3
更新日期:1996-09-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
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更新日期:1991-01-01 00:00:00
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journal_title:Journal of clinical epidemiology
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journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0895-4356(03)00012-x
更新日期:2003-04-01 00:00:00
abstract::Pragmatic trials aim to inform clinical decision making by measuring the effect of a treatment in clinical practice. The purpose of the PRECIS-2 tool is to support in designing a truly pragmatic trial. We comment on a study by Forbes et al., who assessed the applicability of the PRECIS-2 tool. The tool will prove part...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2017.06.006
更新日期:2017-10-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2010.09.009
更新日期:2011-03-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2013.06.003
更新日期:2013-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(99)00016-5
更新日期:1999-05-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2020.04.009
更新日期:2020-08-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.03.004
更新日期:2019-07-01 00:00:00