Abstract
Biostatistics is an essential part when making clinical decisions. Applications of 2×2 contingency tables playing a key role in conducting analysis involving binary variables. When it comes to analysis based on 2×2 contingency tables, most people are familiar with the concept of sensitivity and specificity for evaluating a new test, but predictive values and receiver operating characteristic (ROC) curves would also provide information. Besides, Odds Ratio (OR), Risk Ratio (RR), and Chi-square test are measures based on 2×2 tables and commonly applied in retrospective and prospective studies. This article will first review the two kinds of application of 2×2 contingency tables, evaluating a new test compared with a reference standard, and exploring the relationship of exposures and outcomes in retrospective or prospective studies. Two clinical examples are presented to demonstrate these basic biostatistical concepts: diagnostic accuracy of 64-slice multidetector computed tomography (64-MDCT) to identify periampullary duodenal diverticula, and a randomized clinical trial (RCT) to examine the effectiveness of Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery. Correctly understanding these concepts will assist clinicians and medical researchers to analyze the data and interpret the results, and therefore make accurate decisions in clinical practice.
Highlights
Clinical decision making includes diagnosis and treatment, mostly depending on the results of laboratory tests and medical imaging
When conducting analysis involving binary data, application based on 2×2 contingency table plays a key role and is widespread used in clinical decision making. 2×2 contingency tables are commonly used in clinical decision making
Count b and c are recognized as false positive (FP) and false negative (FN), respectively, which indicates that the result of new test is opposite to that of the standard test
Summary
Clinical decision making includes diagnosis and treatment, mostly depending on the results of laboratory tests and medical imaging. Retrospective case-control studies and prospective cohort studies use Odds Ratio (OR), Risk Ratio (RR), and Chisquare test to explore the relationship between exposures and outcomes These measures are all based on the contingency tables. The first part of this article will summarize the application of 2×2 contingency tables and the relevant statistical concepts in the context of comparing a new test to a reference standard and exploring the relationship between exposures and outcomes. In the latter part, two clinical examples are provided following the concept introduced to help understand the methodology used for clinical decision making
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