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Methods to Estimate the Optimal Threshold for Normally or Log-Normally Distributed Biological Tests

Author

Listed:
  • Jérôme Jund

    (Department of Biostatistics, Hospices Civils de Lyon, Lyon, France, dim.jjund@ch-annecy.fr)

  • Muriel Rabilloud

    (Department of Biostatistics, Hospices Civils de Lyon, Lyon, France)

  • Martine Wallon

    (Department of Parasitology, Hospices Civils de Lyon, Lyon, France)

  • René Ecochard

    (Department of Biostatistics, Hospices Civils de Lyon, Lyon, France)

Abstract

Putting a screening or a diagnostic test into everyday use requires the determination of its threshold. The authors present methods that yield a point and an interval estimation of the threshold that maximize the population utility whenever the test results are normally or log-normally distributed among healthy and among diseased subjects, with equal variances. These methods were assessed for bias, coverage probability, coverage symmetry, and confidence-interval width using simulation. They proved to be asymptotically nonbiased and to have a satisfactory coverage probability whenever the sample sizes of the healthy and the diseased subjects are equal to or greater than 50. The methods were next applied to determine an optimal threshold for the antibody load used to diagnose congenital toxoplasmosis at birth. The methods are easy to implement and impose few constraints; however, the sample sizes should be carefully determined according to the required accuracy.

Suggested Citation

  • Jérôme Jund & Muriel Rabilloud & Martine Wallon & René Ecochard, 2005. "Methods to Estimate the Optimal Threshold for Normally or Log-Normally Distributed Biological Tests," Medical Decision Making, , vol. 25(4), pages 406-415, July.
    • Handle: RePEc:sae:medema:v:25:y:2005:i:4:p:406-415
    DOI: 10.1177/0272989X05276855
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    References listed on IDEAS

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    1. Eugene Somoza & Douglas Mossman, 1992. "Comparing and Optimizing Diagnostic Tests," Medical Decision Making, , vol. 12(3), pages 179-188, August.
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    Cited by:

    1. Subtil, Fabien, 2011. "Comments on the article of C.-Y. Lai, L. Tian, and E.F. Schisterman on the "Exact confidence interval estimation for the Youden index and its corresponding optimal cut-point"," Computational Statistics & Data Analysis, Elsevier, vol. 55(12), pages 3379-3380, December.

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