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A non‐inferiority test for diagnostic accuracy based on the paired partial areas under ROC curves
Author(s) -
Li ChiRong,
Liao ChenTuo,
Liu JenPei
Publication year - 2007
Publication title -
statistics in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.996
H-Index - 183
eISSN - 1097-0258
pISSN - 0277-6715
DOI - 10.1002/sim.3121
Subject(s) - receiver operating characteristic , parametric statistics , statistics , diagnostic accuracy , computer science , diagnostic test , mathematics , test (biology) , significant difference , algorithm , pattern recognition (psychology) , artificial intelligence , medicine , radiology , emergency medicine , paleontology , biology
Abstract Non‐inferiority is a reasonable approach to assessing the diagnostic accuracy of a new diagnostic test if it provides an easier administration or reduces the cost. The area under the receiver operating characteristic (ROC) curve is one of the common measures for the overall diagnostic accuracy. However, it may not differentiate the various shapes of the ROC curves with different diagnostic significances. The partial area under the ROC curve (PAUROC) may present an alternative that can provide additional and complimentary information for some diagnostic tests which require false‐positive rate that does not exceed a certain level. Non‐parametric and maximum likelihood methods can be used for the non‐inferiority tests based on the difference in paired PAUROCs. However, their performance has not been investigated in finite samples. We propose to use the concept of generalized p ‐value to construct a non‐inferiority test for diagnostic accuracy based on the difference in paired PAUROCs. Simulation results show that the proposed non‐inferiority test not only adequately controls the size at the nominal level but also is uniformly more powerful than the non‐parametric methods. The proposed method is illustrated with a numerical example using published data. Copyright © 2007 John Wiley & Sons, Ltd.