Power calculation for comparing diagnostic accuracies in a multi-reader, multi-test design

Biometrics. 2014 Dec;70(4):1033-41. doi: 10.1111/biom.12240. Epub 2014 Oct 29.

Abstract

Receiver operating characteristic (ROC) analysis is widely used to evaluate the performance of diagnostic tests with continuous or ordinal responses. A popular study design for assessing the accuracy of diagnostic tests involves multiple readers interpreting multiple diagnostic test results, called the multi-reader, multi-test design. Although several different approaches to analyzing data from this design exist, few methods have discussed the sample size and power issues. In this article, we develop a power formula to compare the correlated areas under the ROC curves (AUC) in a multi-reader, multi-test design. We present a nonparametric approach to estimate and compare the correlated AUCs by extending DeLong et al.'s (1988, Biometrics 44, 837-845) approach. A power formula is derived based on the asymptotic distribution of the nonparametric AUCs. Simulation studies are conducted to demonstrate the performance of the proposed power formula and an example is provided to illustrate the proposed procedure.

Keywords: Multi-reader; Multi-test design; Power; Receiver operating characteristic curve; Sample size; U-statistics.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Algorithms*
  • Computer Simulation
  • Data Interpretation, Statistical
  • Diagnosis, Computer-Assisted / methods*
  • Models, Statistical*
  • Observer Variation*
  • ROC Curve*
  • Reproducibility of Results
  • Research Design*