Abstract
The purpose of the present work was to investigate the validity of using single-reader-adapted receiver operating characteristics (ROC) software for analysis of visual grading characteristics (VGC) data. VGC data from four published VGC studies on optimisation of X-ray examinations, previously analysed using ROCFIT, were reanalysed using a recently developed software dedicated to VGC analysis (VGC Analyzer), and the outcomes [the mean and 95 % confidence interval (CI) of the area under the VGC curve (AUCVGC) and the p-value] were compared. The studies included both paired and non-paired data and were reanalysed both for the fixed-reader and the random-reader situations. The results showed good agreement between the softwares for the mean AUCVGC For non-paired data, wider CIs were obtained with VGC Analyzer than previously reported, whereas for paired data, the previously reported CIs were similar or even broader. Similar observations were made for the p-values. The results indicate that the use of single-reader-adapted ROC software such as ROCFIT for analysing non-paired VGC data may lead to an increased risk of committing Type I errors, especially in the random-reader situation. On the other hand, the use of ROC software for analysis of paired VGC data may lead to an increased risk of committing Type II errors, especially in the fixed-reader situation.
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