In receiver operating characteristic (ROC) curve analysis, the optimal cutoff value for a diagnostic test can be found on the ROC curve where the slope of the curve is equal to (C/B) x (1-p[D])/p[D], where p[D] is the disease prevalence and C/B is the ratio of net costs of treating nondiseased individuals to net benefits of treating diseased individuals.
We conducted a structured review of the medical literature to examine C/B ratios found in ROC curve analysis.
Only two studies were found in which a C/B ratio was explicitly calculated ; in another 11 studies, a C/B ratio was based on a so-called holistic estimate, an all-encompassing educated estimate of the relative costs and benefits relevant to the clinical situation.
The C/B ratios ranged from 0.0025 (tuberculosis screening) to 2.7 (teeth restoration for carious lesions).
Clinical scenarios that are directly life threatening but curable had C/B ratios of less than 0.05.
This analysis led us to construct a table of ordered C/B ratios that may be used by investigators to approximate C/B ratios for other clinical situations in order to establish cutpoints for new diagnostic tests.
Mots-clés Pascal : Méthode ROC, Diagnostic, Technique, Examen laboratoire, Validation test, Spécificité, Sensibilité, Ratio, Epidémiologie, Méthodologie, Evaluation performance, Analyse avantage coût, Homme, Prise décision, Etude comparative
Mots-clés Pascal anglais : Receiver operating characteristic curves, Diagnosis, Technique, Laboratory investigations, Test validation, Specificity, Sensitivity, Ratio, Epidemiology, Methodology, Performance evaluation, Cost benefit analysis, Human, Decision making, Comparative study
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0483518
Code Inist : 002B30A01A1. Création : 22/03/2000.