TY - JOUR
T1 - A comparison of C/B ratios from studies using receiver operating characteristic curve analysis
AU - Cantor, Scott B.
AU - Sun, Charlotte C.
AU - Tortolero-Luna, Guillermo
AU - Richards-Kortum, Rebecca
AU - Follen, Michele
N1 - Funding Information:
This study was funded, in part, by support from the National Science Foundation/The Whitaker Foundation “Integration of Optical Engineering, Efficacy and Cost Analyses to Improve Diagnosis of Cervical Pre-Cancer.” This manuscript was improved by suggestions made by J. Robert Beck, Robert Centor, Dennis Fryback, Michael Kattan, Lore Feldman, Walter Pagel, and colleagues in the Section of General Internal Medicine of The University of Texas M. D. Anderson Cancer Center.
PY - 1999/9
Y1 - 1999/9
N2 - In receiver operating characteristic (ROC) curve analysis, the optimal cutoff value for a diagnostic test can be found on the ROC curve where the slope of the curve is equal to (C/B) x (1-p[D])/p[D], where p[D] is the disease prevalence and C/B is the ratio of net costs of treating nondiseased individuals to net benefits of treating diseased individuals. We conducted a structured review of the medical literature to examine C/B ratios found in ROC curve analysis. Only two studies were found in which a C/B ratio was explicitly calculated; in another 11 studies, a C/B ratio was based on a so-called holistic estimate, an all-encompassing educated estimate of the relative costs and benefits relevant to the clinical situation. The C/B ratios ranged from 0.0025 (tuberculosis screening) to 2.7 (teeth restoration for carious lesions). Clinical scenarios that are directly life threatening but curable had C/B ratios of less than 0.05. This analysis led us to construct a table of ordered C/B ratios that may be used by investigators to approximate C/B ratios for other clinical situations in order to establish cutpoints for new diagnostic tests. Copyright (C) 1999 Elsevier Science Inc.
AB - In receiver operating characteristic (ROC) curve analysis, the optimal cutoff value for a diagnostic test can be found on the ROC curve where the slope of the curve is equal to (C/B) x (1-p[D])/p[D], where p[D] is the disease prevalence and C/B is the ratio of net costs of treating nondiseased individuals to net benefits of treating diseased individuals. We conducted a structured review of the medical literature to examine C/B ratios found in ROC curve analysis. Only two studies were found in which a C/B ratio was explicitly calculated; in another 11 studies, a C/B ratio was based on a so-called holistic estimate, an all-encompassing educated estimate of the relative costs and benefits relevant to the clinical situation. The C/B ratios ranged from 0.0025 (tuberculosis screening) to 2.7 (teeth restoration for carious lesions). Clinical scenarios that are directly life threatening but curable had C/B ratios of less than 0.05. This analysis led us to construct a table of ordered C/B ratios that may be used by investigators to approximate C/B ratios for other clinical situations in order to establish cutpoints for new diagnostic tests. Copyright (C) 1999 Elsevier Science Inc.
KW - Cost-benefit analysis
KW - Decision support techniques
KW - Laboratory diagnosis
KW - ROC curve
KW - Routine diagnostic tests
KW - Sensitivity and specificity
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U2 - 10.1016/S0895-4356(99)00075-X
DO - 10.1016/S0895-4356(99)00075-X
M3 - Article
C2 - 10529029
AN - SCOPUS:0033198348
SN - 0895-4356
VL - 52
SP - 885
EP - 892
JO - Journal of clinical epidemiology
JF - Journal of clinical epidemiology
IS - 9
ER -