Spectrum bias

Spectrum bias

Initially identified in 1978cite journal |author=Ransohoff DF, Feinstein AR |title=Problems of spectrum and bias in evaluating the efficacy of diagnostic tests |journal=N. Engl. J. Med. |volume=299 |issue=17 |pages=926–30 |year=1978 |pmid=692598 |doi=] , spectrum bias refers to evaluating the ability of a diagnostic test in a biased group of patients which leads to an overestimation of the sensitivity and specificity of the test.cite journal |author=Goehring C, Perrier A, Morabia A |title=Spectrum bias: a quantitative and graphical analysis of the variability of medical diagnostic test performance |journal=Statistics in medicine |volume=23 |issue=1 |pages=125–35 |year=2004 |pmid=14695644 |doi=10.1002/sim.1591] Examples are initial overestimates of the sensitivity and specificity of the carcinoembryonic antigencite journal |author=Fletcher RH |title=Carcinoembryonic antigen |journal=Ann. Intern. Med. |volume=104 |issue=1 |pages=66–73 |year=1986 |pmid=3510056 |doi=] and urinary dipstick tests.cite journal |author=Lachs MS, Nachamkin I, Edelstein PH, Goldman J, Feinstein AR, Schwartz JS |title=Spectrum bias in the evaluation of diagnostic tests: lessons from the rapid dipstick test for urinary tract infection |journal=Ann. Intern. Med. |volume=117 |issue=2 |pages=135–40 |year=1992 |pmid=1605428 |doi=]

The inflated results can occur when the diagnostic test is compared in a healthy population versus a population with advanced disease.

If properly analyzed, recognition of heterogeneity of subgroups can lead to insights about the test's performance in varying populations.cite journal |author=Mulherin SA, Miller WC |title=Spectrum bias or spectrum effect? Subgroup variation in diagnostic test evaluation |journal=Ann. Intern. Med. |volume=137 |issue=7 |pages=598–602 |year=2002 |pmid=12353947 |doi=]

References

ee also

* Biased sample


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