Utility Flashcards
According to article, what’s wrong with traditional indexes like specificity, sensitivity, PPV, and NPV?
They vary based on cutoff scores, base rates, and cost/benefits with a particular context or assessment.
What do the article authors encourage to do?
Use methods of signal detection theory, like ROC for utility
What happens when cutoff scores change? Which of the following are affected? (Selection Ratio, Base Rate, Sensitivity, Specificity, Positive Predictive Power, Negative Predictive Power)
Only base rate does not change.
What metrics are directly affected by the base rate?
PPV and NPV
What is the ROC-based index is independent of?
1) base rate / prevalence
2) cutoff score
3) values of the 4 decision-making outcomes (i.e., TN TP FN FP)
How to use ROC analysis?
Look at area under ROC curve. This shows discriminative power of an assessment independent of cutoff value
What does it mean when AUC = 1?
What about when AUC = 0.5 or less than 0.5?
When AUC = 1, the model is perfect across all cutoffs. Sensitivity and Specificity both are 100%
When AUC = 0.5, it’s no better than guessing.
When AUC < 0.5, the test inverts values
Test Utility
Usefulness or practical value of testing to improve efficiency
3 factors for utility of a test (what makes it have high/low utility?)
1) psychometric soundness (validity + reliability)
2) costs
3) benefits
Does utility require measuring something?
No, there can be utility without measurement
Is utility an empirical or conceptual endeavour?
Empirical
How are costs complicated?
It’s complicated to calculate costs due to nonmonetary costs. (eg. what are the costs of not administering a test, resulting in possibly failing to diagnose a disease?)
What general procedure determines costs and benefits of a test?
Utility analysis
Expectancy data
One way of doing utility analyses. Uses predictions of outcomes to judge the benefits of a test?
What does a Taylor-Russell table accomplish?
A type of expectancy data.
Helps to see how much using a test will improve selection over existing method