Spectrum bias
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Initially identified in 1978[1], spectrum bias refers to evaluating the ability of a diagnostic test in a biased group of patients which leads to an overestimation of the sensitivity and specificity of the test.[1][2] Examples are initial overestimates of the sensitivity and specificity of the carcinoembryonic antigen[3] and urinary dipstick tests.[4]
The inflated results can occur when the diagnostic test is compared in a healthy population versus a population with advanced disease.
If properly analyzed, recognition of heterogeneity of subgroups can lead to insights about the test's performance in varying populations.[5]
References
- ↑ 1.0 1.1 Ransohoff DF, Feinstein AR (1978). "Problems of spectrum and bias in evaluating the efficacy of diagnostic tests". N. Engl. J. Med. 299 (17): 926-30. PMID 692598.
- ↑ Goehring C, Perrier A, Morabia A (2004). "Spectrum bias: a quantitative and graphical analysis of the variability of medical diagnostic test performance". Statistics in medicine 23 (1): 125-35. doi:10.1002/sim.1591. PMID 14695644.
- ↑ Fletcher RH (1986). "Carcinoembryonic antigen". Ann. Intern. Med. 104 (1): 66-73. PMID 3510056.
- ↑ Lachs MS, Nachamkin I, Edelstein PH, Goldman J, Feinstein AR, Schwartz JS (1992). "Spectrum bias in the evaluation of diagnostic tests: lessons from the rapid dipstick test for urinary tract infection". Ann. Intern. Med. 117 (2): 135-40. PMID 1605428.
- ↑ Mulherin SA, Miller WC (2002). "Spectrum bias or spectrum effect? Subgroup variation in diagnostic test evaluation". Ann. Intern. Med. 137 (7): 598-602. PMID 12353947.
See also
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Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
