Questions tagged [diagnosis]

medical diagnosis: diagnostic accuracy and diagnostic research

This tag relates to medical diagnosis, including quantifying diagnostic accuracy, designing diagnostic studies, and optimizing diagnosis. It is a good place to discuss the pros and cons of various measures of diagnostic accuracy, including significant problems inherent in traditional measures such as sensitivity, specificity, positive predictive value, and negative predictive value. These measures assume that the diagnosis is all-or-nothing and likewise for diagnostic tests, and do not properly handle continuous diagnostic markers. Sensitivity and specificity have special problems in that they envision the problem in backwards time order / backwards information flow. This leads to all kinds of interpretation problems, made worse by non-constancy of sensitivity and specificity over different types of patients. Some background and alternative approaches may be found in Biostatistics for Biomedical Research, Chapter 18 under http://biostat.mc.vanderbilt.edu/ClinStat .

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Interpretation of Bayes Theorem applied to positive mammography results

I'm trying to wrap my head around the result of Bayes Theorem applied to the classic mammogram example, with the twist of the mammogram being perfect. That is, Incidence of cancer: $.01$ Probability of a positive mammogram, given the patient has…
user2666425
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Which statistical model to use when trying to find the beginning of a time-dependent increase

I have a repeated measures data set with time as the independent variable and a single dependent variable, y. That is, for each subject, I have a certain (small, from 1 to 3) number of measurements. The maximum time point of all measurements is a…
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Correction for multiple testing required for combined metrics

Let's say I compare two diagnostic procedures (A and B) and want to check if one outperforms the other one using the metric diagnostic accuracy where diagnostic accuracy is commonly described using sensitivity and specificity. I want to test for…
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The different usage of ROC between diagnotic tests and machine learning

I am currently very confused about the ROC usage in diagnostic tests and machine learning. In the scenario of medical diagnostic studies, many tutorial does not mention the data split procedure as often highlighted in machine learning courses, and…
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What happens with sensitivity and specificity after a second test?

What happens with sens/spec and PPV/NPV if one performs a test twice (or three times etc.)? I will give an example from my own clinical practice. At many hospitals we have a problem with multiresistant bacteria, e.g. MRSA. Classic tests for…
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Conflicting definitions of logistic regression

I do diagnostic research and am interested in determining how the probability of a patient having cancer is related to the concentration of different molecules in the blood. I have received conflicting information on what specifically counts as…
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when add-on test is necessary? better diagnosis strategy

Suppose there are two types of tests available. Test A: low-cost, but relatively less precise; Test B: high-cost, but more precise. Test B can be considered as the good standard with 100% accuracy. Suppose there is a group of patients with different…
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Relationship between ROC curve and statistical significance in comparison of two groups

My question is about any possible relationship between the significance of a comparison test (Mann-Whitney U) and the ROC curve. If the comparison test is strongly significant, should we expect a better ROC curve, and consequently better NPV, PPV…
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P-curve analysis for meta-analysis of diagnostic accuracy study

I tried to do a meta-analysis of diagnostic accuracy study. I found out that I have a publication bias based on the Deek's regression test. Thus, I want to supplement my analysis with P-curve analysis which I read from here. The author used the…
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Probability of disease in a patient with risk factor

I'm a doctor so I'm sorry for my basic knowledge of statisctics. I have a prior probability of the disease D $$P(D) = 0.12$$ I know that risk factor RF can cause the disease. Total probability of RF among population is $$P(RF) = 0.05$$ Also I know…
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Network meta-analysis of correlation coefficients: a logical paradox?

A colleague of mine wishes to conduct a network meta-analysis of correlation coefficients for a set of imaging tests (eg ultrasound, computed tomography, magnetic resonance imaging, and so forth). He has collected correlation coefficients (R),…
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Post-hoc power calculation for AUC analysis, to evaluate a new diagnostic test in a cohort

I need some urgent advice for a grant application. I am evaluating a new diagnostic test and at the last minute a Professor has offered me the dataset from a completed prospective study of the disease my test diagnoses. He wants me to check if his…
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Network meta-analysis of diagnostic test accuracy studies

I need to make a network meta-analysis of diagnostic studies. Is there a good explanation to do it with R?
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Calculating sensitivity and specificity from survival data

I have a diagnostic test performed on 100 participants at baseline. I then follow up these participants for variable periods of time and have data regarding survival. I have used a Cox regression model to calculate a hazard ratio, and used the…
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Handling incomplete information properly when using Bayes' theorem

Just for fun I'm trying to do some simple medical diagnosis using Bayes' theorem. Right now I'm calculating P(condition | symptoms) = P(symptoms | condition) * P(condition) for each possibly condition, then choosing the most likely condition given…
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