Abstract：
OBJECTIVES:The receiver operating characteristic curves (ROC curves) are often used to compare continuous diagnostic tests or determine the optimal threshold of a test; however, they do not consider the costs of misclassifications or the disease prevalence. The ROC graph was extended to allow for these aspects. STUDY DESIGN AND SETTING:Two new lines are added to the ROC graph: a sensitivity line and a specificity line. Their slopes depend on the disease prevalence and on the ratio of the net benefit of treating a diseased subject to the net cost of treating a nondiseased one. First, these lines help researchers determine the range of specificities within which test comparisons of partial areas under the curves is clinically relevant. Second, the ROC curve point the farthest from the specificity line is shown to be the optimal threshold in terms of expected utility. RESULTS:This method was applied: (1) to determine the optimal threshold of ratio specific immunoglobulin G (IgG)/total IgG for the diagnosis of congenital toxoplasmosis and (2) to select, among two markers, the most accurate for the diagnosis of left ventricular hypertrophy in hypertensive subjects. CONCLUSION:The two additional lines transform the statistically valid ROC graph into a clinically relevant tool for test selection and threshold determination.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Subtil F,Rabilloud Mdoi
10.1016/j.jclinepi.2015.01.003subject
Has Abstractpub_date
2015-07-01 00:00:00pages
752-9issue
7eissn
0895-4356issn
1878-5921pii
S0895-4356(15)00005-0journal_volume
68pub_type
杂志文章abstract：:I argue in this paper that the use of a global clinical impression of change as a primary measure in dementia drug trials is appropriate, given that we do not yet understand clearly enough what Alzheimer's disease looks like as it gets better. ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)90039-6
更新日期：1994-01-01 00:00:00
abstract：OBJECTIVE:To provide information concerning the magnitude of the intraclass correlation coefficient (ICC) for cluster-based studies set in primary care. STUDY DESIGN AND SETTING:Reanalysis of data from 31 cluster-based studies in primary care to estimate intraclass correlation coefficients from random effects models u...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jclinepi.2003.12.013
更新日期：2004-08-01 00:00:00
abstract：OBJECTIVES:In this article, we describe how to include considerations about resource utilization when making recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. STUDY DESIGN AND SETTINGS:We focus on challenges with rating the confidence in effect estima...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2012.04.012
更新日期：2013-02-01 00:00:00
abstract：:A literature search identified eight articles containing data on both baldness and coronary artery disease (CAD). Three of these articles described case-control studies that showed a positive relationship between baldness and CAD when controlling for CAD risk factors. Three other case-control studies showed no such re...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/0895-4356(90)90026-l
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVE:We examined whether a breast cancer risk prediction model other than the Gail et al. model performs better at discriminating between women who will and who will not develop the disease. METHODS:We applied the two published versions of the Rosner and Colditz log-incidence model of breast cancer, developed on ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(03)00124-0
更新日期：2003-09-01 00:00:00
abstract：:The effect of age, sex, diabetes, hypertension, pulse rate and cigarette smoking on extracranial carotid artery plaque thickness evaluated by B-mode ultrasonography was investigated in a cross-sectional study of 698 white men, 730 white women, 77 black men and 76 black women as part of a clinical ultrasound registry. ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(89)90151-0
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVES:To identify, describe, and map contemporary nutrition guidelines (NGs) from reviews that used the Appraisal of Guidelines, Research and Evaluation (AGREE) tool. STUDY DESIGN AND SETTING:We performed an overview of reviews that systematically assessed the quality of NGs using the AGREE tool. We searched MEDL...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2018.08.018
更新日期：2018-12-01 00:00:00
abstract：:We assessed the performance of diagnostic electrocardiogram (ECG) interpretation by the computer program MEANS and by research physicians, compared to cardiologists, in a physician-based study. To establish a strategy for ECG interpretation in health surveys, we also studied the diagnostic capacity of three scenarios:...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(97)00100-5
更新日期：1997-08-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Serial measurements obtained during observational longitudinal studies offer the opportunity to describe the effects of chronic diseases on patient-centered outcomes such as quality of life. The purpose of this study was to assess serial Asthma Quality of Life Questionnaire (AQLQ) and SF-36 sco...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/S0895-4356(03)00248-8
更新日期：2004-01-01 00:00:00
abstract：OBJECTIVES:In a twinning partnership between the Canadian Society for International Health and Kazakhstan's Ministry of Health, a project to build capacity and a process for the adaptation and implementation of international clinical practice guidelines (CPGs) was undertaken. STUDY DESIGN AND SETTING:A pragmatic CPG a...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2015.05.001
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:When contamination is present, randomization on a patient level leads to dilution of the treatment effect. The usual solution is to randomize on a cluster level, but at the cost of efficiency and more importantly, this may introduce selection bias. Furthermore, it may slow down recruitment in ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2005.10.003
更新日期：2006-04-01 00:00:00
abstract：:Coronary heart disease (CHD) is an imprecise, inappropriate monitor of atherosclerosis severity and by inapplicable extrapolation CHD risk factors are incorrectly assumed to be causes of atherosclerosis. Taking into account (1) the misuse and substantial diagnostic error of CHD, (2) errors in determining the prevalenc...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/0895-4356(90)90231-d
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVE:Hospital mortality outcomes for acute myocardial infarction (AMI) patients are a focus of quality improvement programs conducted by government agencies. AMI mortality risk-adjustment models using administrative data typically adjust for baseline differences in mortality risk with a limited set of common and d...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.05.014
更新日期：2007-02-01 00:00:00
abstract：OBJECTIVE:Adding risk factors to a prediction model often increases the area under the receiver operating characteristic curve (AUC) only slightly, particularly when the AUC of the model was already high. We investigated whether a risk factor that minimally improves the AUC may nevertheless improve the predictive abili...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2016.07.002
更新日期：2016-11-01 00:00:00
abstract：:A standardized examination protocol was developed for the assessment of low back disorders in primary care. The protocol was found feasible in the occupational health service setting. The interexaminer repeatability between an occupational physician and an occupational physiotherapist was good for most items. The pred...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(97)00266-7
更新日期：1998-03-01 00:00:00
abstract：:We develop a stochastic model of screening for ovarian cancer with serum levels of the CA 125 radioimmunoassay, a tumor-specific marker. The natural history of the disease is constructed using a four stage model characterized by a multivariate distribution for duration in each stage. Preserving its important features,...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(91)90075-k
更新日期：1991-01-01 00:00:00
abstract：:The objective of our study was to assess the applicability of using estimates of within-person variance (WPV) from reproducibility studies for a correction of blood pressure values in another study to improve the accuracy of the prevalence estimation of hypertension. Data were collected from two cross-sectional popula...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(00)00228-6
更新日期：2000-11-01 00:00:00
abstract：OBJECTIVE:To compare the discriminatory ability of Rasch-based and summative scoring in the context of assessing upper limb function of patients with stroke. STUDY DESIGN AND SETTING:Data were from a cohort study of 497 adults with stroke undergoing physiotherapy. Upper limb function was assessed at admission and disc...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2012.12.014
更新日期：2013-06-01 00:00:00
abstract：OBJECTIVE:To examine the relationships between study quality, author prestige, journal impact factors, and citation rates of trials and to examine whether journal impact factors mediated the relationships between study quality and author prestige on citation rates. STUDY DESIGN AND SETTING:We used bibliometric data fr...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2016.01.028
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVES:We sought to identify the proportion of systematic reviews of adverse effects which search for unpublished data and the success rates of identifying unpublished data for inclusion in a systematic review. STUDY DESIGN AND SETTING:Two reviewers independently screened all records published in 2014 in the Datab...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2016.05.003
更新日期：2016-09-01 00:00:00
abstract：OBJECTIVE:Risk difference (RD) is often estimated from relative association measures generated by meta-analysis and a particular group's baseline risk. We describe a problematic situation in using this approach. STUDY DESIGN AND SETTING:We encountered a meta-analysis in which a confidence interval (CI) of relative ris...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2008.11.005
更新日期：2009-08-01 00:00:00
abstract：:This study assesses psychometric properties of the Modified Mini-Mental State Exam (3MS) and present population norms and demographic risk factors for low 3MS scores. The subjects were 885 persons aged 65 and older who took the 3MS as part of the Stirling County Study, a population-based longitudinal study of adult re...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(03)00111-2
更新日期：2003-07-01 00:00:00
abstract：:In replication of two recent studies, it was intended to show that headache symptoms obtained by means of questionnaires fit a categorial model, provided that appropriate methods of data analysis are used. In addition, the questions which are best posed to obtain a succinct classification should be determined. Configu...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)00182-p
更新日期：1995-06-01 00:00:00
abstract：OBJECTIVES:To review James Jackson's analysis of bloodletting among pneumonitis patients at the newly founded Massachusetts General Hospital, in which he implemented the numerical method advocated by Pierre-Charles-Alexandre Louis. STUDY DESIGN AND SETTING:The study sample included 34 cases of clinically diagnosed pne...
journal_title：Journal of clinical epidemiology
pub_type： 传,历史文章,杂志文章
doi：10.1016/j.jclinepi.2014.10.013
更新日期：2015-04-01 00:00:00
abstract：OBJECTIVES:The objective of this study was to analyze adequacy of judgments about risk of bias (RoB) for blinding of participants and personnel (performance bias) in Cochrane systematic reviews of randomized controlled trials (RCTs). STUDY DESIGN AND SETTING:We extracted judgments and supporting comments for performan...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.05.012
更新日期：2019-09-01 00:00:00
abstract：OBJECTIVES:The objective of the study is to estimate the proportion of statistically significant survival improvements reported in randomized trials of cancer treatments that are also compatible with a clinically negligible benefit. STUDY DESIGN AND SETTING:This is a cross-sectional study of reports of randomized clin...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2020.06.026
更新日期：2020-11-01 00:00:00
abstract：OBJECTIVE:To compare and contrast clinical epidemiology and population health perspectives on the role of health care in reducing socioeconomic disparities in health. STUDY DESIGN AND SETTING:A review of concepts outlined in selected articles on population health and clinical epidemiology and a systematic literature s...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2004.10.020
更新日期：2005-08-01 00:00:00
abstract：:The uses of hypothesis in scientific medicine and in clinical medicine are broadly similar; but they differ in subtle but important logical details. The key distinction is that scientific medicine deals with broad ("public") hypotheses about entire populations; and the predominant problem of inference is statistics in...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(89)90028-0
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:This study evaluated search strategies for finding high-quality studies on treatment and systematic reviews in PsycINFO. STUDY DESIGN AND SETTING:Sixty-four journals were hand searched at McMaster University. Methodologic criteria were applied to clinically relevant articles to identify "pass" and "fail" art...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.09.016
更新日期：2008-01-01 00:00:00
abstract：:A visible result of the 20-year old applied ethics movement is the use of moral philosophers as quotable newspaper sources. In situations like the op-ed page, adequate space and time allows for serious reflection, and the columns provide accessible, quality ideas for the general public. Quality usually disappears wh...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(92)90058-u
更新日期：1992-07-01 00:00:00
