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. PMID 692598. [e]
- ↑ 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. PMID 14695644. Research Blogging.
- ↑ Fletcher RH (1986). "Carcinoembryonic antigen". Ann. Intern. Med. 104 (1): 66-73. PMID 3510056. PMID 3510056. [e]
- ↑ 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. PMID 1605428. [e]
- ↑ 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. PMID 12353947. [e]