鏂规硶瀛﹁瘎浠峰父鐢ㄦ寚鏍
鍙戝竷鏃堕棿锛
鏉ユ簮锛
棣栧厛鍒朵綔鐩稿叧鍥涙牸琛紝鍐嶆牴鎹〃鏍兼暟鎹绠楃浉搴旀寚鏍囥€侟/p>
| 璇婃柇璇曢獙锛堟柊鏂规硶) | 閲戞爣鍑嗘垨鍙傛瘮鏂规硶 | 鍚堣 | |
| 鏈夌梾鎴栭槼鎬э紙n锛堻/td> | 鏃犵梾鎴栭槾鎬э紙n锛堻/td> | ||
| 闃虫€?/td> | a锛堢湡闃虫€э級 | b锛堝亣闃虫€э級 | a+b |
| 闃存€?/td> | c锛堝亣闃存€э級 | d锛堢湡闃存€э級 | c+d |
| 鍚堣 | a+c | b+d | a+b+c+d |
1銆佽瘎浠疯瘖鏂瘯楠岀湡瀹炴€х殑鎸囨爣
锛?锛夌伒鏁忓害( sensitivity) 锛氭寚鎮ｈ€呬腑璇曢獙闃虫€ц€呮墍鍗犳瘮渚嬨€侟br />
璁＄畻鍏紡锛氱伒鏁忓害( Sen) = a/( a+ c) % 100%銆侟br />
锛?锛夌壒寮傚害( specificity) 锛氭寚娌℃湁鎮ｇ梾鐨勪汉涓瘯楠岄槾鎬ц€呮墍鍗犳瘮渚嬨€侟br />
璁＄畻鍏紡锛氱壒寮傚害( Spe) = d/ ( b+ d) % 100%銆侟br />
浠ヤ笂涓や釜鎸囨爣鏄瘎浠疯瘖鏂瘯楠岀湡瀹炴€х殑鍩烘湰鎸囨爣锛 鑻ヤ緷鎹洓鏍艰〃涓璦銆乥銆乧銆乨 4 涓疄娴嬪€肩殑姒傜巼鍏崇郴鍒欙細Sen= 1- c/( a+ c)(鍋囬槾鎬х巼) 锛 Spe= 1- b/ ( b+ d) (鍋囬槼鎬х巼) 锛 浜岃€呮湁浜掕ˉ鍏崇郴銆侟br />
锛?锛夎璇婄巼( mistake diagnostic rate锛?alpha;)锛氬張绉板亣闃虫€х巼锛 鍗抽潪鎮ｈ€呬腑琚瘖鏂瘯楠屽垽涓洪槼鎬х殑姒傜巼銆侟br />
璁＄畻鍏紡锛氳璇婄巼(α) = b/( b+ d) % 100%銆侟br />
锛?锛夋紡璇婄巼( omission diagnostic rate锛?beta;)锛氬張绉板亣闃存€х巼锛 鍗虫偅鑰呬腑琚瘖鏂瘯楠屽垽涓洪槾鎬х殑姒傜巼銆侟br />
璁＄畻鍏紡锛氭紡璇婄巼(β)= c/ ( a+ c) % 100%銆侟br />
锛?锛夌矖涓€鑷寸巼( crude agreement rate)锛氬張绉板噯纭害( accuracy) 銆傝〃绀鸿瀵熷€间笌鐪熷疄鍊肩鍚堢殑绋嬪害锛 鏄患鍚堣€冭檻鐪熷疄鎬х殑鎸囨爣銆傛槸鐪熼槼鎬т笌鐪熼槾鎬т箣鍜屽崰鍙楁鎬讳汉鏁扮殑鐧惧垎鐜囥€侟br />
璁＄畻鍏紡锛氬噯纭害= ( a+ d)/( a+ b+ c+ d) % 100%銆侟br />
锛?锛夌害鐧绘寚鏁? Youden’s indx锛孻I )锛氬張绉版纭寚鏁般€傛寚鐏垫晱搴︿笌鐗瑰紓搴︿箣鍜屽噺1 琛ㄧず锛 鏁呮鎸囨暟鍊肩殑鑼冨洿鍙粠0~ 1銆傜害鐧绘寚鏁拌秺澶э紝 鍏剁湡瀹炴€т害瓒婂ソ銆侟br />
璁＄畻鍏紡锛歒I= [ a/( a+ c)+ d/( b+ d) ] - 1銆侟br />
锛?锛夋瘮鏁扮Н( odds product锛孫P)锛氭寚鐏垫晱搴﹂櫎浠ユ紡璇婄巼锛 鐗瑰紓搴﹂櫎浠ヨ璇婄巼锛 鎵€鑾蜂袱姣旀暟鐨勪箻绉€傛瘮鏁扮Н瓒婂ぇ锛 璇婃柇璇曢獙鐨勭湡瀹炴€ц秺濂姐€侟br />
璁＄畻鍏紡锛歄P= [ Sen/( 1- Sen) ] ×[ Spe/( 1- Spe) ] = ad/bc锛 浣嗚姹傚洓鏍艰〃鍐呯殑鏁板瓧鍧囦笉涓洪浂銆侟br />
锛?锛変技鐒舵瘮( likelihood ratio 锛孡R) 锛氭槸璇婃柇璇曢獙鐨勭粨鏋滃湪鎮ｈ€呬腑鍑虹幇鐨勬鐜囦笌闈炴偅鑰呬腑鍑虹幇鐨勬鐜囦箣姣斻€備技鐒舵瘮鏄瘎浠疯瘖鏂瘯楠岀湡瀹炴€х殑閲嶈缁煎悎鎸囨爣锛 鍏朵紭鐐规槸闈炲父绋冲畾锛 涓嶅彈鎮ｇ梾鐜囩殑褰卞搷銆備技鐒舵瘮鍒嗕负浠ヤ笅2 绉嶇被鍨嬶細
闃虫€т技鐒舵瘮( positive likelihood ratio锛? LR)锛氭寚鐪熼槼鎬х巼鍜屽亣闃虫€х巼涔嬫瘮銆侟br />
璁＄畻鍏紡锛?LR= [ a/( a+ c) ]/[ b/ ( b+ d) ] % 100%銆侟br />
闃存€т技鐒舵瘮( negative likelihood锛? LR) 锛氭寚鍋囬槾鎬х巼鍜岀湡闃存€х巼涔嬫瘮銆侟br />
璁＄畻鍏紡锛?LR= [ c/( a+ c) ]/[ d/( b+d) ] % 100%銆侟br />
鍦ㄩ€夋嫨璇婃柇璇曢獙鏃跺簲褰撻€夋嫨闃虫€т技鐒舵瘮澶х殑璇曢獙锛 鍥犲叾浠ｈ〃闃虫€х粨鏋滅殑姝ｇ‘鐜囥€傚悓鏃跺簲褰撻€夋嫨闃存€т技鐒舵瘮灏忕殑璇曢獙銆傚洜鍏朵唬琛ㄩ槾鎬х粨鏋滅殑姝ｇ‘鐜囥€侟br />
锛?锛夐娴嬪€? predictive value锛孭V) 锛氭寚璇婃柇璇曢獙缁撴灉涓庡疄闄呯鍚堢殑姒傜巼锛 涔熷彲浠ユ妸棰勬祴鍊煎綊涓鸿瘎浠疯瘖鏂瘯楠岀粨鏋滅殑鎸囨爣銆傚洜涓哄浜庝复搴婂尰甯堟潵璇达紝 鑷冲叧閲嶈鐨勬槸鍦ㄥ凡鐭ヨ妫€鏌ュ璞＄殑璇曢獙缁撴灉( 闃虫€ф垨闃存€? 鐨勬潯浠朵笅锛 鍐冲畾鍏舵槸鍚︽湁鐥呰繕鏄棤鐥呯殑姒傜巼鏈夊澶ф椂閫氬父鏄牴鎹娴嬪€兼潵鍒ゆ柇銆侟br />
闃虫€ч娴嬪€? + PV) 锛氭寚璇婃柇璇曢獙闃虫€х粨鏋滅殑浜轰腑鏈夌梾鐨勬鐜囷紝
璁＄畻鍏紡锛?PV= a/( a+ b)×100%锛 姝ゅ€艰秺澶ц秺濂姐€侟br />
闃存€ч娴嬪€? - PV) 锛氭寚璇婃柇璇曢獙闃存€х粨鏋滅殑浜轰腑瀹為檯鏃犵梾鐨勬鐜囷紝
璁＄畻鍏紡锛歞/( c+ d)×100%锛 姝ゅ€艰秺澶ц秺濂姐€侟/p>
2銆佽瘎浠疯瘖鏂瘯楠屽彲闈犳€х殑鎸囨爣
鍙潬鎬т篃绉颁负鍙噸澶嶆€э紝 鏄寚璇婃柇璇曢獙鍦ㄥ畬鍏ㄧ浉鍚岀殑鏉′欢涓嬶紝 杩涜閲嶅璇曢獙锛 鑾峰緱鐩稿悓缁撴灉鐨勭ǔ瀹氱▼搴︺€傚父鐢ㄧ殑璇勪环鎸囨爣濡備笅銆侟br />
鏍囧噯宸細涓€鑸互锛堝潎鏁?plusmn;鏍囧噯宸級 鏉ヨ〃绀猴紝 姝ゆ柟娉曟槸鍦ㄨ閲忚祫鏂欐椂浣跨敤銆侟br />
鍙樺紓绯绘暟锛氬嵆鏍囧噯宸笌鍧囨暟涔嬫瘮銆侟br />
璁＄畻鍏紡锛氬彉寮傜郴鏁? 鏍囧噯宸?鍧囨暟 ×100% 銆備竴鑸姹傚彉寮傜郴鏁板簲灏忎簬10%锛 姝ゆ寚鏍囧湪璁￠噺璧勬枡鏃朵娇鐢ㄣ€侟br />
瑙傚療绗﹀悎鐜囷細鍗充袱鍚嶈瀵熻€呭鍚屼竴浜嬬墿鐨勮瀵熸垨鍚屼竴瑙傚療鑰呭鍚屼竴浜嬬墿涓ゆ瑙傚療缁撴灉涓€鑷寸殑鐧惧垎鐜囷紝 渚濇嵁鍥涙牸琛ㄥ叾璁＄畻鍏紡锛欬br />
闃虫€х鍚堢巼=a/锛坅+b锛?times;100%
闃存€х鍚堢巼=d/锛坈+d锛?times;100%
瑙傚療绗﹀悎鐜囷紙鎬荤鍚堢巼锛堼 ( a+ d)/( a+ b+ c+ d)×100%銆侟br />
涓婅堪鏍囧湪缁撴灉涓鸿鏁拌祫鏂欐椂浣跨敤銆侟br />
鍗″笗鍊? Kappa value)锛氭槸璇勪环璁℃暟璧勬枡瑙傚療绗﹀悎绋嬪害鐨勫父鐢ㄦ寚鏍囥€傚彲鐢卞洓鏍艰〃鐩存帴璁＄畻銆傝绠楀叕寮忥細2( ad- bc)/[ ( a+ b) ( b+ d) ( a+ c) ( c+ d) ] 銆侟br />
涓€鑸儏鍐典笅Kappa鍊艰秺澶э紝 绗﹀悎绋嬪害瓒婂ソ銆傚嵆璇婃柇璇曢獙鐨勫彲闈犳€ц秺濂姐€侟br />
鍙楄瘯鑰呭伐浣滅壒鎬ф洸绾? receiver operator charateristic curve锛孯OC)锛歊OC 鏇茬嚎鏄敤鐪熼槼鎬х巼鍜屽亣闃虫€х巼浣滃浘鎵€寰楃殑鏇茬嚎锛 瀹冨彲浠ヨ〃绀虹伒鏁忓害涓庣壒寮傚害涔嬮棿鐨勭浉浜掑叧绯汇€傛牴鎹伒鏁忓害銆佺壒寮傚害浜掕ˉ鍏崇郴鐨勫師鐞嗭紝鐢ㄧ伒鏁忓害涓虹旱鍧愭爣銆佸亣闃虫€х巼涓烘í鍧愭爣浣滃浘锛 鍏舵墍寰楃殑鏇茬嚎鍙敤鏉ュ喅瀹氭渶浣充复鐣岀偣(姝ｅ父鍊? 锛 涓€鑸閫夋嫨鏇茬嚎杞集澶勶紝鍗崇伒鏁忓害涓庣壒寮傚害鍧囪緝楂樼殑鐐? A 鐐? 寰楁渶浣充复鐣岀偣銆侟br />