Advanced Bayesian Methods for Medical Test Accuracy

Description

Useful in many areas of medicine and biology, Bayesian methods are particularly attractive tools for the design of clinical trials and diagnostic tests, which are based on established information, usually from related previous studies. Advanced Bayesian Methods for Medical Test Accuracy begins with a review of the usual measures such as specificity, sensitivity, positive and negative predictive value, and the area under the ROC curve. Then the scope expands to cover the more advanced topics of verification bias, diagnostic tests with imperfect gold standards, and those for which no gold standard is available.

Promoting accuracy and efficiency of clinical trials, tests, and the diagnostic process, this book:

• Enables the user to efficiently apply prior information via a WinBUGS package
• Presents many ideas for the first time and goes far beyond the two standard references
• Integrates reader agreement with different modalities—X-ray, CT Scanners, and more—to study their effect on medical test accuracy
• Provides practical chapter-end problems

Useful for graduate students and consulting statisticians working in the various areas of diagnostic medicine and study design, this practical resource introduces the fundamentals of programming and executing BUGS, giving readers the tools and experience to successfully analyze studies for medical test accuracy.

Features

• Introduces the reader to advanced Bayesian methods for assessing the accuracy of medical test results
• A very practical/computational approach is included through the use of both WinBugs and R code in the examples
• Uses regression techniques to estimate the effect of covariates on test accuracy
• Emphasizes the methods for verification bias and methods for measuring accuracy without gold standards
• Many real life examples will be provided from the author’s wide experience of working in a very large medical center

Table of Contents

• Introduction
• Statistical Methods in Medical Test Accuracy
• Datasets for This Book
• Software
• Bayesian Approach
• References

• Medical Tests and Preliminary Information
• Introduction
• Medical Imaging Tests
• Other Medical Tests
• Activities Involved in Medical Testing
• Accuracy and Agreement
• Developmental Trials for Medical Devices
• Literature
• References

• Preview of the Book
• Introduction
• Preliminary Information
• Fundamentals of Test Accuracy
• Advanced Methods for Test Accuracy
• References

• Fundamentals of Diagnostic Accuracy
• Introduction
• Study Design
• Bayesian Methods for Test Accuracy: Binary and Ordinal Data
• Clustered Data: Detection and Localization
• Comparing Accuracy between Modalities with Ordinal Scores
• Exercises
• References

• Regression and Medical Test Accuracy
• Introduction
• Audiology Study
• Receiver Operating Characteristic Area and Patient Covariates
• Regression Methods for Continuous Test Scores
• Exercises
• References

• Agreement and Test Accuracy
• Introduction
• Ordinal Scores with a Gold Standard
• Continuous Scores with a Gold Standard
• Agreement with Ordinal Scores and No Gold Standard
• Other Measures of Agreement
• Agreement and Test Accuracy
• Kappa and Association
• Consensus
• Agreement with Multiple Raters and Ordinal Scores—No Gold Standard
• Conclusions for Agreement and Accuracy
• Exercises
• References

• Estimating Test Accuracy with an Imperfect Reference Standard
• Introduction
• Two Binary Tests
• Posterior Distribution for Two Binary Tests
• Posterior Distribution without Conditional Independence
• Posterior Distribution Assuming Conditional Independence
• Example of Accuracy for Diagnosing a Bacterial Infection
• Accuracies of Two Binary Tests for Several Populations with Conditional Independence
• Accuracies of Two Binary Tests without Conditional Independence: Two Populations
• Multiple Tests in a Single Population
• Multiple Tests without Conditional Independence
• Two Ordinal Tests and the Receiver Operating
• Characteristic Area
• Exercises
• References

• Verification Bias and Test Accuracy
• Introduction
• Verification Bias and Binary Tests
• Two Binary Tests
• Ordinal Tests and Verification Bias
• Two Ordinal Tests and Verification Bias
• Two Ordinal Tests and Covariates
• Inverse Probability Weighting
• Without the Missing at Random Assumption
• One Ordinal Test and the Receiver Operating Characteristic Area
• Comments and Conclusions
• Exercises
• References

• Test Accuracy and Medical Practice
• Introduction
• Choice of Optimal Threshold
• Test Accuracy with Bayesian Decision Curves
• Test Accuracy and Clinical Trials
• Summary and Conclusions
• Exercises
• References

• Accuracy of Combined Tests
• Introduction
• Two Binary Tests
• Two Binary Tests and Several Readers
• Accuracy of Combined Binary Tests with Verification Bias
• Likelihood Ratio, the Risk Score, the Neyman–Pearson Lemma, and the Accuracy of Multiple Ordinal Tests
• Accuracy of the Combined Test for Continuous Scores
• Observations and Conclusions
• Exercises
• References

• Bayesian Methods for Meta-Analysis
• Introduction
• Summary Receiver Operating Characteristic Curve and Bilogistic Regression
• Bayesian Analysis for Summary Accuracy
• Meta-Analysis with Two Tests
• Meta-Analysis with Study Covariates and One Test
• Meta-Analysis with Covariates for Several Tests
• Other Meta-Analyses
• Comments and Conclusions
• Exercises
• References

• Appendix: Introduction to WinBUGS
• Introduction
• Download
• Essentials
• Output
• Another Example
• Summary
• References

Author

Lyle D. Broemeling, Ph.D., is Director of Broemeling and Associates Inc., and is a consulting biostatistician. He has been involved with academic health science centers for about 20 years and has taught and been a consultant at the University of Texas Medical Branch in Galveston, The University of Texas MD Anderson Cancer Center and the University of Texas School of Public Health. His main interest is in developing Bayesian methods for use in medical and biological problems and in authoring textbooks in statistics. His previous books are Bayesian Analysis of Linear Models, Econometrics and Structural Change(written with Hiraki Tsurumi), Bayesian Biostatistics and Diagnostic Medicine, and Bayesian Methods for Agreement.