1,721,109 research outputs found
How discriminating are discriminative instruments?
Full text linkThe McMaster framework introduced by Kirshner & Guyatt is the dominant paradigm for the development of measures of health status and health-related quality of life (HRQL). The framework defines the functions of such instruments as evaluative, predictive or discriminative. Evaluative instruments are required to be sensitive to change (responsiveness), but there is no corresponding index of the degree to which discriminative instruments are sensitive to cross-sectional differences.This paper argues that indices of validity and reliability are not sufficient to demonstrate that a discriminative instrument performs its function of discriminating between individuals, and that the McMaster framework would be augmented by the addition of a separate index of discrimination. The coefficient proposed by Ferguson (Delta) is easily adapted to HRQL instruments and is a direct, non-parametric index of the degree to which an instrument distinguishes between individuals. While Delta should prove useful in the development and evaluation of discriminative instruments, further research is required to elucidate the relationship between the measurement properties of discrimination, reliability and responsivenes
External validation of anti-Müllerian hormone based prediction of live birth in assisted conception
Full text link<p>Background - Chronological age and oocyte yield are independent determinants of live birth in assisted conception. Anti-Müllerian hormone (AMH) is strongly associated with oocyte yield after controlled ovarian stimulation. We have previously assessed the ability of AMH and age to independently predict live birth in an Italian assisted conception cohort. Herein we report the external validation of the nomogram in 822 UK first in vitro fertilization (IVF) cycles.</p>
<p>Methods - Retrospective cohort consisting of 822 patients undergoing their first IVF treatment cycle at Glasgow Centre for Reproductive Medicine. Analyses were restricted to women aged between 25 and 42 years of age. All women had an AMH measured prior to commencing their first IVF cycle. The performance of the model was assessed; discrimination by the area under the receiver operator curve (ROCAUC) and model calibration by the predicted probability versus observed probability.</p>
<p>Results - Live births occurred in 29.4% of the cohort. The observed and predicted outcomes showed no evidence of miscalibration (p = 0.188). The ROCAUC was 0.64 (95% CI: 0.60, 0.68), suggesting moderate and similar discrimination to the original model. The ROCAUC for a continuous model of age and AMH was 0.65 (95% CI 0.61, 0.69), suggesting that the original categories of AMH were appropriate.</p>
<p>Conclusions - We confirm by external validation that AMH and age are independent predictors of live birth. Although the confidence intervals for each category are wide, our results support the assessment of AMH in larger cohorts with detailed baseline phenotyping for live birth prediction.</p>
Partial and differential verification in diagnostic accuracy studies Abstract [Oral: O06-1]
No full textBivariate and SROC regression models in meta-analysis of studies of diagnostic accuracy (Oral)
No full textMeta-analysis and meta-modelling for diagnostic problems
No full textBackgroundA proportional hazards measure is suggested in the context of analyzing SROC curves that arise in the meta–analysis of diagnostic studies. The measure can be motivated as a special model: the Lehmann model for ROC curves. The Lehmann model involves study–specific sensitivities and specificities and a diagnostic accuracy parameter which connects the two.MethodsA study–specific model is estimated for each study, and the resulting study-specific estimate of diagnostic accuracy is taken as an outcome measure for a mixed model with a random study effect and other study-level covariates as fixed effects. The variance component model becomes estimable by deriving within-study variances, depending on the outcome measure of choice. In contrast to existing approaches – usually of bivariate nature for the outcome measures – the suggested approach is univariate and, hence, allows easily the application of conventional mixed modelling.ResultsSome simple modifications in the SAS procedure proc mixed allow the fitting of mixed models for meta-analytic data from diagnostic studies. The methodology is illustrated with several meta–analytic diagnostic data sets, including a meta–analysis of the Mini–Mental State Examination as a diagnostic device for dementia and mild cognitive impairment.ConclusionsThe proposed methodology allows us to embed the meta-analysis of diagnostic studies into the well–developed area of mixed modelling. Different outcome measures, specifically from the perspective of whether a local or a global measure of diagnostic accuracy should be applied, are discussed as well. In particular, variation in cut-off value is discussed together with recommendations on choosing the best cut-off value. We also show how this problem can be addressed with the proposed methodology
Study design features affect estimates of sensitivity and specificity, but effects may vary Abstract [Oral Abstract: O03-9]
No full textSources of bias in diagnostic accuracy studies [Bronnen van bias in onderzoek naar diagnostische accuratesse] [oral]
No full textThe accuracy of D-dimer testing in suspected pulmonary embolism varies with the Wells score
No full textvan Es J, Beenen LFM, Gerdes VEA, Middeldorp S, Douma RA, Bossuyt PMM. The accuracy of D-dimer testing in suspected pulmonary embolism varies with the Wells score. J Thromb Haemost 2012; 10: 2630
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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