Diagnostics 2013, 3(1), 192-209; doi:10.3390/diagnostics3010192
Article

Analysis of Predictive Values Based on Individual Risk Factors in Multi-Modality Trials

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Received: 23 January 2013; in revised form: 25 February 2013 / Accepted: 13 March 2013 / Published: 15 March 2013
(This article belongs to the Special Issue Feature Papers)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract: The accuracy of diagnostic tests with binary end-points is most frequently measured by sensitivity and specificity. However, from the clinical perspective, the main purpose of a diagnostic agent is to assess the probability of a patient actually being diseased and hence predictive values are more suitable here. As predictive values depend on the pre-test probability of disease, we provide a method to take risk factors influencing the patient’s prior probability of disease into account, when calculating predictive values. Furthermore, approaches to assess confidence intervals and a methodology to compare predictive values by statistical tests are presented. Hereby the methods can be used to analyze predictive values of factorial diagnostic trials, such as multi-modality, multi-reader-trials. We further performed a simulation study assessing length and coverage probability for different types of confidence intervals, and we present the R-Package facROC that can be used to analyze predictive values in factorial diagnostic trials in particular. The methods are applied to a study evaluating CT-angiography as a noninvasive alternative to coronary angiography for diagnosing coronary artery disease. Hereby the patients’ symptoms are considered as risk factors influencing the respective predictive values.
Keywords: positive predictive value; negative predictive value; diagnostic trials; coronary artery disease
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MDPI and ACS Style

Lange, K.; Brunner, E. Analysis of Predictive Values Based on Individual Risk Factors in Multi-Modality Trials. Diagnostics 2013, 3, 192-209.

AMA Style

Lange K, Brunner E. Analysis of Predictive Values Based on Individual Risk Factors in Multi-Modality Trials. Diagnostics. 2013; 3(1):192-209.

Chicago/Turabian Style

Lange, Katharina; Brunner, Edgar. 2013. "Analysis of Predictive Values Based on Individual Risk Factors in Multi-Modality Trials." Diagnostics 3, no. 1: 192-209.

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