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Statistical methods in epidemiology. VIII. On the use of likelihood ratios for diagnostic testing with an application
1Academic Department of Cardiology, University of Hull, Kingston-Upon-Hull, UK. asr1960@hotmail.com
Purpose:
An array of statistical methods is available for 2 x 2 contingency table analysis. These include odds ratios, reliability coefficients and the Chi-squared test. This paper continues the '2 x 2' theme but extends it to look at diagnostic testing. The setting is primary care, the disease is urological cancer.
Method:
Several statistical indices are discussed to measure diagnostic efficiency; these include sensitivity, specificity and the likelihood ratio. The latter can be converted into a flexible 'weight of evidence', which is equivalent to the naive Bayes' discriminant.
Results:
The utility of the naive Bayes' discriminant is illustrated in a primary care setting.
Conclusion:
The naive Bayes' discriminant has proved to be the most durable of statistical discriminants in medical diagnosis. The reason for its durability is ease of use. Despite a concern about independence, it remains a popular choice as a diagnostic aid.
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