ROC curve regression analysis: the use of ordinal regression models for diagnostic test assessment.

Diagnostic tests commonly are characterized by their true positive (sensitivity) and true negative (specificity) classification rates, which rely on a single decision threshold to classify a test result as positive. A more complete description of test accuracy is given by the receiver operating characteristic (ROC) curve, a graph of the false positive and true positive rates obtained as the decision threshold is varied. A generalized regression methodology, which uses a class of ordinal regression models to estimate smoothed ROC curves has been described. Data from a multi-institutional study comparing the accuracy of magnetic resonance (MR) imaging with computed tomography (CT) in detecting liver metastases, which are ideally suited for ROC regression analysis, are described. The general regression model is introduced and an estimate for the area under the ROC curve and its standard error using parameters of the ordinal regression model is given. An analysis of the liver data that highlights the utility of the methodology in parsimoniously adjusting comparisons for covariates is presented

Use of an Inner-city Well-baby Clinic

This prospective, longitudinal investigation examined factors that influenced the use of well-baby services among a low-income, minority, high-risk group. The health belief model was used as the theoretical framework. Data were collected from 44 primiparous, black mothers attending an urban maternal child health care clinic by interviews at the first and sixth months after the birth of their infants. Analysis focused on the cues component of the model and explored the kinds of cues that influenced the mothers to bring their babies to the well-baby clinic. One important finding was that for mothers influenced by health information from radio or television, FYI commercials on television were most often reported.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72805/1/j.1525-1446.1987.tb00535.x.pd