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Multiple reading procedures: The performance of diagnostic tests
Author(s) -
Lachenbruch Peter A.
Publication year - 1988
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.4780070502
Subject(s) - unanimity , test (biology) , sensitivity (control systems) , computer science , reading (process) , predictive value , subject (documents) , diagnostic test , statistics , mathematics , medicine , pediatrics , linguistics , paleontology , electronic engineering , library science , political science , law , biology , engineering , philosophy
Abstract This paper examines the effects on sensitivity and specificity of various multiple reading procedures. Multiple reading procedures entail the performance of a diagnostic test several times and consequent assignment of the subject to an ‘affected’ or ‘unaffected’ group. A Unanimity rule (that is, all tests must be positive) leads to the largest predictive value positive, but may have unacceptably low sensitivity. The rule which classifies the subject as positive based on the majority of the tests increases both the sensitivity and specificity of the individual test. Variability of subjects' sensitivity and specificity (that is, case of correct diagnosis on a test) affects the performance of these rules. We also study alternative procedures in which the final test is a better, but more expensive, test.