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- Nonparametric and Semiparametric Group Sequential Methods for Comparing Accuracy of Diagnostic Tests
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- Abstract:
- Comparison of the accuracy of two diagnostic tests using the receiver operating characteristic
(ROC) curves from two diagnostic tests has been typically conducted using fixed sample
designs. On the other hand, the human experimentation inherent in a comparison of diagnostic
modalities argues for periodic monitoring of the accruing data to address many issues related to the
ethics and efficiency of the medical study. To date, very little research has been done in the use of
sequential sampling plans for comparative ROC studies, even when these studies may use expensive
and unsafe diagnostic procedures. In this paper, we propose a nonparametric group sequential design
plan. The nonparametric sequential method adapts a nonparametric family of weighted area under
the ROC curve statistics (Wieand et al., Biometrika, 76: 585-592, 1989) and a group sequential
sampling plan. We illustrate the implementation of this nonparametric approach for sequentially
comparing ROC curves in the context of diagnostic screening for non-small cell lung cancer. We also
describe a semiparametric sequential method based on proportional hazard models. We compare the
statistical properties of the nonparametric approach to alternative semiparametric and parametric
analyses in simulation studies. The results show the nonparametric approach is robust to model
misspecification and has excellent finite sample performance.
- Subject Area:
- General Biostatistics
- Suggested Citation:
- Liansheng Tang, Scott S. Emerson, and Xiao-Hua Zhou,
"Nonparametric and Semiparametric Group Sequential Methods for Comparing Accuracy of Diagnostic Tests"
(October 22, 2007).
UW Biostatistics Working Paper Series.
Working Paper 316.
http://www.bepress.com/uwbiostat/paper316