Evaluation and application of diagnostic accuracy in clinical decision-making

Abstract

A diagnostic test is any kind of medical test performed to determine the presence or absence of a disease when a subject shows signs or symptoms of the disease. Measures of diagnostic accuracy tell us about the ability of a test to discriminate between disease and health. There are many measures used to show the accuracy of the diagnostic test including sensitivity, specificity, etc. We calculate these measures in 2×2 table, comparing with gold standard and it is possible only when result of the gold standard as well as new test is dichotomous nature. Many diagnostic test results have continuous scale and for such variable a series of cutoff points for disease and corresponding measures of accuracy can be calculated using receiver operating characteristics curve. In this article, we have discussed the various measures of diagnostic accuracy and their computational methods commonly used to assess the performance of a diagnostic test.