Abstract
Patient management relies on diagnostic information to identify appropriate treatment. Standard evaluations of diagnostic tests consist of estimating sensitivity, specificity, positive/negative predictive values, likelihood ratios, and accuracy. Although useful, these metrics do not convey the tests’ clinical value, which is critical to informing decision-making. Full appreciation of the clinical impact of a diagnostic test requires analyses that integrate sensitivity and specificity, account for the disease prevalence within the population of test application, and account for the relative importance of specificity vs sensitivity by considering the clinical implications of false-positive and false-negative results. We developed average weighted accuracy (AWA), representing a pragmatic metric of diagnostic yield or global utility of a diagnostic test. AWA can be used to compare test alternatives, even across different studies. We apply the AWA methodology to evaluate a new diagnostic test developed in the Rapid Diagnostics in Categorizing Acute Lung Infections (RADICAL) study.
The management of infectious disease relies very heavily on diagnostic information. Current standard evaluations of diagnostic tests do not effectively convey the clinical significance of the test, which is critical to informing clinical decision-making. AWA provides an alternative whereby the goal is to evaluate diagnostic utility using a holistic perspective.
Reference Type
Journal Article
Periodical Full
Clinical infectious diseases
Publication Year
2020
Publication Date
Jun 10,
Volume
70
Issue
12
Start Page
2736
Other Pages
2742
Publisher
Oxford University Press
Place of Publication
US
ISSN/ISBN
1058-4838
Document Object Index
10.1093/cid/ciz437
URL
https://www.ncbi.nlm.nih.gov/pubmed/31157863
PMID
31157863