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首页> 外文期刊>Acta Radiologica >Analysis of diagnostic confidence: application to data from a prospective randomized controlled trial of CT for acute abdominal pain.
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Analysis of diagnostic confidence: application to data from a prospective randomized controlled trial of CT for acute abdominal pain.

机译：诊断置信度分析：应用于前瞻性CT急性腹痛随机对照试验的数据。

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BACKGROUND: Changes in diagnostic confidence are used as a measure of a test's efficacy. There are several methods for analyzing such data, but it is unclear which are most robust. PURPOSE: To compare analytical methods for assessing diagnostic confidence, applied to data from a prospective study of computed tomography (CT) for acute abdominal pain. MATERIAL AND METHODS: Changes in diagnostic confidence in an illustrative case study were evaluated using five methods: "Basic," "Retained diagnosis," "Omary," "Tsushima," and "Score-based." The case study was a randomized controlled trial of patients admitted to hospital for acute abdominal pain for whom immediate CT was not indicated, comparing early Admitting surgeons recorded their diagnoses and confidences (5-point scale, 10-90%) both on admission and after 24 h. One- and two-sample t tests, and intention-to-treat and as-treated analyzes, were performed using all five analytic methods. RESULTS: In the case study, 118 patients were randomized to early CT (n=55) or standard practice (n=63). Mean (SD) diagnostic confidence increased between the two time points by 20.7 (25.2)% and 13.0 (24.9)%, respectively. Early CT showed increases in diagnostic confidence by all one-sample analyzes (all P<0.055). Compared with standard practice, early CT showed significant increases in diagnostic confidence on an a) as-treated basis when using Basic, Omary and Score-based analyzes (P<0.045), but not by the other two analytic methods, and b) intention-to-treat, only by Omary analysis. CONCLUSION: The method of analysis used to evaluate diagnostic confidence can influence conclusions about a test's efficacy. Methods incorporating the soundest analytical principles are recommended.
机译：背景：诊断置信度的变化用作测试功效的量度。有几种分析此类数据的方法，但尚不清楚哪种方法最可靠。目的：为了比较评估诊断置信度的分析方法，该方法应用于来自计算机断层扫描（CT）的急性腹痛前瞻性研究的数据。材料和方法：使用五个方法评估了示例性案例研究中的诊断置信度变化：“基本”，“保留诊断”，“ Omary”，“ Tsushima”和“基于得分”。案例研究是一项针对因急性腹痛入院但未立即行CT检查的患者的随机对照试验，比较了早期入院医生在入院时和入院后均记录了其诊断和置信度（5分制，10-90％） 24小时使用所有五种分析方法进行了一次和两次样本t检验，以及意向性治疗和经处理的分析。结果：在该案例研究中，将118例患者随机分为早期CT（n = 55）或标准治疗（n = 63）。在两个时间点之间，平均（SD）诊断置信度分别增加了20.7（25.2）％和13.0（24.9）％。早期CT显示，所有一次样品分析的诊断置信度均有提高（所有P <0.055）。与标准做法相比，早期CT在使用a，按基本，基于Omary和Score的分析进行治疗时显示出诊断置信度显着提高（P <0.045），但未通过其他两种分析方法获得; b）意图处理，仅通过Omary分析。结论：用于评估诊断置信度的分析方法可能会影响有关测试功效的结论。建议采用最合理的分析原理。

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