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Recurrent events counted in evaluations of predictive accuracy.
Terry P Haines1, Keith D Hill, Kim L Bennell
1The University of Melbourne, Peter James Centre, The University of Queensland and Princess Alexandra Hospital, c/o Physiotherapy Department, Princess Alexandra Hospital, Woolloongabba, Queensland 4102, Australia. terrence_haines@health.qld.gov.au
A new method, Sensitivity(ER) and Specificity(ER), improves screening tool accuracy assessment. This approach is valuable for clinical settings, especially with recurrent events and unequal follow-up times.
Area of Science:
- Biostatistics
- Clinical Epidemiology
- Health Informatics
Background:
- Standard sensitivity and specificity calculations may be inadequate for screening tools with recurrent events or unequal participant follow-up.
- Accurate assessment of screening tool performance is crucial for effective clinical decision-making.
Purpose of the Study:
- To introduce and describe an alternative method for calculating sensitivity and specificity, termed Sensitivity(ER) and Specificity(ER).
- To demonstrate the utility of this alternate approach when standard calculations are inappropriate for screening tool accuracy analysis.
Main Methods:
- Applied standard and the alternate Sensitivity(ER) and Specificity(ER) methods to hospital falls risk screening tool data.
- Utilized bootstrap resampling to estimate variance, accounting for event dependence in the alternate method.
- Addressed complexities including recurrent events, multiple screening applications, and unequal follow-up durations.
Main Results:
- Sensitivity(ER) and Specificity(ER) provided a clearer description of the screening tool's overall accuracy.
- Enabled examination of accuracy over time, prediction of specific event numbers, and evaluation of repeated screenings.
- Demonstrated the added value of reapplying screening tools in clinical settings.
Conclusions:
- Sensitivity(ER) and Specificity(ER) offer a valuable and adaptable approach for evaluating screening tool performance.
- This method enhances the assessment of screening tool accuracy in complex clinical scenarios.
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