Statistics in medicine
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Statistics in medicine · Dec 2010
Summary ROC curve based on a weighted Youden index for selecting an optimal cutpoint in meta-analysis of diagnostic accuracy.
Established approaches for analyzing meta-analyses of diagnostic accuracy model the bivariate distribution of the observed pairs of specificity Sp and sensitivity Se, thus accounting for across-study correlation. However, it is still a matter of debate how to define a summary ROC (SROC) curve. It was recently pointed out that the SROC curve is in principle unidentifiable if only one (Sp, Se) pair per study is known. ⋯ While the slope depends on the variance ratio of the underlying distributions, the intercept is a function of the mean difference. Our approach leads in a natural way to a new, model-based proposal for a summary ROC curve. It is illustrated using an example from the literature.