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C-statistics versus logistic regression for assessing the performance of qualitative diagnostic tests

  • Cesar Romero , Leonard te Velde , Huibert Ponsen and Ton J. Cleophas EMAIL logo
Published/Copyright: September 26, 2011
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Clinical Chemistry and Laboratory Medicine
From the journal Clinical Chemistry and Laboratory Medicine Volume 50 Issue 1

Abstract

Background: Qualitative diagnostic tests commonly produce false positive and false negative results. Smooth receiver operated characteristic (ROC) curves are used for assessing the performance of a new test against a standard test. This method, called c-statistic (concordance) has limitations. The aim of this study was to assess whether logistic regression with the odds of disease as an outcome and the test scores as covariate, can be used as an alternative approach, and to compare the performance of either of the two methods.

Methods: Using as examples simulated by vascular laboratory scores we assessed the performance of logistic regression as compared to c-statistics.

Results: The c-statistics produced areas under the curve (AUCs) of respectively 0.954 and 0.969 (standard errors 0.007 and 0.005), means difference 0.015 with a pooled standard error of 0.0086. This meant that the new test was not significantly different from the standard test at p=0.08. Logistic regression of these data with presence of disease as a dependent and vascular laboratory scores as an independent variable produced regression coefficients of 0.45 and 0.58 with standard errors of respectively 0.04 and 0.05. This meant that the new test was a significantly better predictor of disease than the standard test at p=0.04.

Conclusions: Logistic regression with presence of disease as a dependent and test scores as an independent variable was better than c-statistics for assessing qualitative diagnostic tests. This may be relevant to future diagnostic research.

Keywords: c-statistics; diagnostic tests; logistic regression; ROC curves
Corresponding author: Professor Ton J. Cleophas, Department of Medicine, Albert Schweitzer Hospital Dordrecht, Box 444, 3300AH Dordrecht, The Netherlands Phone: +31 184 434222, Fax: +31 184 434340
Received: 2011-8-7
Accepted: 2011-9-2
Published Online: 2011-09-26
Published in Print: 2012-01-01

©2011 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/cclm.2011.726
Keywords for this article
c-statistics; diagnostic tests; logistic regression; ROC curves

Articles in the same Issue

  1. Editorial
  2. Targeted therapy for HER-2: personalized medicine for her, too
  3. Review
  4. Circulating levels of HER-2/neu oncoprotein in breast cancer
  5. Mini Review
  6. The human epidermal growth factor receptor 2 (HER2)
  7. Opinion Paper
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  9. Guidelines and Recommendations
  10. Properties and units in the clinical laboratory sciences, Part XXIII. The NPU terminology, principles and implementation –a user’s guide (Technical Report 2011) (IFCC–IUPAC)
  11. Genetics and Molecular Diagnostics
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  17. Detection and quantification of M-proteinemia: comparison of various methods for serum protein electrophoresis
  18. External quality assessment of point-of-care International Normalized Ratio (INR) testing in Europe
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  25. The diagnostic performance of allergen-molecules in comparison to allergen-extracts
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  28. Reference Values and Biological Variations
  29. Diurnal variability of total calcium during normal sleep and after an acute shift of sleep
  30. Infections Diseases
  31. Comparison of two immunoassays for determining hepatitis B virus serum markers
  32. Cardiovascular Diseases
  33. Ultra-sensitive troponin I levels to exclude acute myocardial infarction from myocardial injury
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