{"title":"重新考虑认知筛查工具的准确性:总体、平衡还是无偏准确性?","authors":"Andrew J Larner","doi":"10.2217/nmt-2021-0049","DOIUrl":null,"url":null,"abstract":"<p><p><b>Aim:</b> To examine three different accuracy metrics for evaluation of cognitive screening instruments: overall correct classification accuracy (Acc), the sum of true positives and negatives divided by the total number tested; balanced accuracy (balanced Acc), half of the sum of sensitivity and specificity; and unbiased accuracy (unbiased Acc), removing biasing effects of random associations between test results and disease prevalence. <b>Materials & methods:</b> Data from a prospective test accuracy study of Mini-Addenbrooke's Cognitive Examination were used to calculate and plot the Acc measures. <b>Results:</b> Each Acc metric resulted in a similar pattern of results across the range of Mini-Addenbrooke's Cognitive Examination cut-offs for diagnosis of both dementia and mild cognitive impairment. Acc and balanced Acc gave more optimistic outcomes (closer to possible maximum value of 1) than unbiased Acc. <b>Conclusion:</b> Unbiased Acc may have advantages over Acc and balanced Acc by removing biasing effects of random associations between test result and disease prevalence.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 2","pages":"67-76"},"PeriodicalIF":2.3000,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"7","resultStr":"{\"title\":\"Accuracy of cognitive screening instruments reconsidered: overall, balanced or unbiased accuracy?\",\"authors\":\"Andrew J Larner\",\"doi\":\"10.2217/nmt-2021-0049\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Aim:</b> To examine three different accuracy metrics for evaluation of cognitive screening instruments: overall correct classification accuracy (Acc), the sum of true positives and negatives divided by the total number tested; balanced accuracy (balanced Acc), half of the sum of sensitivity and specificity; and unbiased accuracy (unbiased Acc), removing biasing effects of random associations between test results and disease prevalence. <b>Materials & methods:</b> Data from a prospective test accuracy study of Mini-Addenbrooke's Cognitive Examination were used to calculate and plot the Acc measures. <b>Results:</b> Each Acc metric resulted in a similar pattern of results across the range of Mini-Addenbrooke's Cognitive Examination cut-offs for diagnosis of both dementia and mild cognitive impairment. Acc and balanced Acc gave more optimistic outcomes (closer to possible maximum value of 1) than unbiased Acc. <b>Conclusion:</b> Unbiased Acc may have advantages over Acc and balanced Acc by removing biasing effects of random associations between test result and disease prevalence.</p>\",\"PeriodicalId\":19114,\"journal\":{\"name\":\"Neurodegenerative disease management\",\"volume\":\"12 2\",\"pages\":\"67-76\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2022-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurodegenerative disease management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2217/nmt-2021-0049\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/2/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurodegenerative disease management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2217/nmt-2021-0049","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/2/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Accuracy of cognitive screening instruments reconsidered: overall, balanced or unbiased accuracy?
Aim: To examine three different accuracy metrics for evaluation of cognitive screening instruments: overall correct classification accuracy (Acc), the sum of true positives and negatives divided by the total number tested; balanced accuracy (balanced Acc), half of the sum of sensitivity and specificity; and unbiased accuracy (unbiased Acc), removing biasing effects of random associations between test results and disease prevalence. Materials & methods: Data from a prospective test accuracy study of Mini-Addenbrooke's Cognitive Examination were used to calculate and plot the Acc measures. Results: Each Acc metric resulted in a similar pattern of results across the range of Mini-Addenbrooke's Cognitive Examination cut-offs for diagnosis of both dementia and mild cognitive impairment. Acc and balanced Acc gave more optimistic outcomes (closer to possible maximum value of 1) than unbiased Acc. Conclusion: Unbiased Acc may have advantages over Acc and balanced Acc by removing biasing effects of random associations between test result and disease prevalence.