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Joint estimation of disease-specific sensitivities and specificities in reader-based multi-disease diagnostic studies of paired organs

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  • N. Withanage
  • A.R. de Leon
  • C.J. Rudnisky

Abstract

Binocular data typically arise in ophthalmology where pairs of eyes are evaluated, through some diagnostic procedure, for the presence of certain diseases or pathologies. Treating eyes as independent and adopting the usual approach in estimating the sensitivity and specificity of a diagnostic test ignores the correlation between fellow eyes. This may consequently yield incorrect estimates, especially of the standard errors. The paper is concerned with diagnostic studies wherein several diagnostic tests, or the same test read by several readers, are administered to identify one or more diseases. A likelihood-based method of estimating disease-specific sensitivities and specificities via hierarchical generalized linear mixed models is proposed to meaningfully delineate the various correlations in the data. The efficiency of the estimates is assessed in a simulation study. Data from a study on diabetic retinopathy are analyzed to illustrate the methodology.

Suggested Citation

  • N. Withanage & A.R. de Leon & C.J. Rudnisky, 2014. "Joint estimation of disease-specific sensitivities and specificities in reader-based multi-disease diagnostic studies of paired organs," Journal of Applied Statistics, Taylor & Francis Journals, vol. 41(10), pages 2282-2297, October.
    • Handle: RePEc:taf:japsta:v:41:y:2014:i:10:p:2282-2297
    DOI: 10.1080/02664763.2014.909790
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    References listed on IDEAS

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    1. Steffen Fieuws & Geert Verbeke, 2006. "Pairwise Fitting of Mixed Models for the Joint Modeling of Multivariate Longitudinal Profiles," Biometrics, The International Biometric Society, vol. 62(2), pages 424-431, June.
    2. de Leon, A.R. & Zhu, Y., 2008. "ANOVA extensions for mixed discrete and continuous data," Computational Statistics & Data Analysis, Elsevier, vol. 52(4), pages 2218-2227, January.
    3. Renard, Didier & Molenberghs, Geert & Geys, Helena, 2004. "A pairwise likelihood approach to estimation in multilevel probit models," Computational Statistics & Data Analysis, Elsevier, vol. 44(4), pages 649-667, January.
    4. D. R. Cox, 2004. "A note on pseudolikelihood constructed from marginal densities," Biometrika, Biometrika Trust, vol. 91(3), pages 729-737, September.
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