可视化诊断测试和预测模型的价值,第I部分:介绍和预期的效用作为预测概率函数的效用
Michael A Kohn1, Thomas B Newman1
1Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Journal of clinical epidemiology
|January 26, 2025
概括
预期效益 (EGU) 计算有助于临床医生评估诊断测试的价值. 较低的预测试概率需要更异常的测试结果来证明治疗的合理性,平衡好处与危害.
科学领域:
- 临床决策分析 临床决策分析
- 诊断测试评价 诊断测试评价 诊断测试评价
背景情况:
- 本研究介绍了预期效益 (EGU) 计算,这是探索诊断测试价值的系列中的第一个.
- 作为一个案例,使用血D-二聚体检测肺栓塞的实用性.
研究的目的:
- 解释预期效益 (EGU) 计算和图形表示.
- 展示EGU如何取决于预测概率,治疗益处和危害.
主要方法:
- 临床医生的决策过程是模拟的:没有测试/治疗,基于结果的测试/治疗,或没有测试的治疗.
- 简单的代数和图形被用来说明EGU的依赖性.
主要成果:
- 治疗值概率 (EGU=0) 被定义为C/(C+B),其中B是治疗的益处,C是不必要的治疗的危害.
- 最佳的临床决定取决于预测试概率,测试结果,以及测试和治疗的危害 (T) 和益处 (B,C).
结论:
- EGU的计算和图表可视化了诊断测试的价值.
- 影响测试价值的关键因素包括疾病概率,治疗疗效和相关危害.
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