Recommended methods to compare the accuracy of two binary diagnostic tests subject to a paired design

ABSTRACT

This manuscript assesses different methods to compare the sensitivities and the specificities of two diagnostic tests. It studies the comparison conditioning on the disease status and testing each hypothesis test individually to an error $\alpha$, a global hypothesis test to simultaneously compare the parameters, and the individual comparison of the parameters along with the multiple comparison methods of Bonferroni and Holm. Simulation experiments were carried out to study the global type I errors and the global powers of the different methods, providing some general rules of application. When the prevalence is small and the sample size is small or moderate, it is recommended to compare the parameters individually along with the method of Bonferroni or Holm; in any other situation, it is recommended to compare the parameters simultaneously through a global test. The results were applied to an example of the diagnosis of coronary disease.

KEYWORDS:

• Binary diagnostic test
• global hypothesis test
• sensitivity
• specificity

MATHEMATICS SUBJECT CLASSIFICATIONS:

• 62P10
• 6207

Acknowledgements

We thank the Editor, the Associate Editor and the Referee for their helpful comments that improved the quality of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

J.A. Roldán-Nofuentes http://orcid.org/0000-0003-0251-5588

Additional information

Funding

This research was supported by the Ministry of Economy of Spain [grant number MTM2016-76938-P].