Signal Detection Theory and Roc Analysis in Psychology and Diagnostics: Collected Papers

By John A. Swets | Go to book overview

6
Medical Imaging Techniques: A Review

Fundamental to the evaluation of a medical imaging technique is a reliable and valid measure of diagnostic accuracy. Ideally, an assessment of accuracy will be expressed in such terms that it can also serve as the basis for a valid description of that technique's utility, in terms of cost and benefit.

The relative operating characteristic (ROC) is the single analytic technique known to provide both the desired accuracy index and the desired basis for a description of utility. The reliability and validity of the ROC's accuracy index stem from the fact that this index reflects only the inherent discrimination factors of the diagnostic alternatives for an image reader. This index, specifically, is unaffected by decision factors, ie, by a reader's tendencies to favor or disfavor one diagnostic alternative, tendencies which will vary both between readers and within a reader. Further, the ROC analysis yields the particular balance or trade off among all image-based decision probabilities--including the probabilities of various correct and incorrect decisions--that will result from any particular decision factors that the investigator might want to specify. Therefore, in evaluating the utility of an imaging technique, by pursuing a decision flow diagram from the imaging stage to outcomes at some further stage, the investigator can begin with appropriate image based decision probabilities. The appropriate trade off among image-based decision probabilities will be the one that reflects the values, costs, and other event probabilities, that the investigator believes are inherent in that diagnostic/therapeutic technique, rather than the trade off that happens to be yielded by any test reader.

This report focuses on the use of the ROC in assessing technique accuracy. I begin with a brief review of the basic concepts of ROC analysis, emphasizing contrasts between the ROC's accuracy index and certain other indices commonly used in medical evaluation.

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Signal Detection Theory and Roc Analysis in Psychology and Diagnostics: Collected Papers
Table of contents

Table of contents

  • Scientific Psychology Series ii
  • Title Page iii
  • Contents v
  • Preface vii
  • Acknowledgments xi
  • Introduction xiii
  • I - Theory, Data, and Measures 1
  • 1 - The Relative Operating Characteristic in Psychology 7
  • Summary 28
  • References and Notes 29
  • 2 - Form of Empirical Rocs in Discrimination and Diagnostic Tasks 31
  • References 56
  • 3 - Indices of Discrimination or Diagnostic Accuracy 59
  • References 95
  • II - Accuracy and Efficacy of Diagnoses 97
  • 4 - Measuring the Accuracy of Diagnostic Systems 99
  • Concluding Remarks 115
  • References and Notes 116
  • 5 - Choosing the Right Decision Threshold in High-Stakes Diagnostics 121
  • Concluding Remarks 140
  • References 141
  • III - Applications in Various Diagnostic Fields 143
  • 6 - Medical Imaging Techniques: A Review 147
  • Summary 164
  • References 165
  • 7 - Medical Imaging Techniques: An Illustrative Study 169
  • 8 - Enhancing and Evaluating Diagnostic Accuracy 185
  • References 199
  • Appendix a Feature List 199
  • Appendix B Checklist 201
  • 9 - Information Retrieval Methods 205
  • Appendix a Feature List 233
  • 10 - Predictive Validities of Aptitude Tests 235
  • References 248
  • 11 - Accuracy and Response Bias in Survey Research 249
  • Conclusions 267
  • References 267
  • 12 - System Operator Response to Warnings of Danger 269
  • References 290
  • Appendix: Computer Programs for Fitting Rocs 293
  • Author Index 295
  • Subject Index 303
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